scholarly journals National Early Warning Score Parameters at the Emergency Department as In Hospital Cardiac Arrest Predictors

2020 ◽  
Vol 2 (4) ◽  
pp. 1-9
Author(s):  
Samsul Maarif ◽  
Teguh Wahju Sardjono ◽  
Yuliani Wiji Utami
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Systolic Blood Pressure ◽  
Respiration Rate ◽  
Predictive Value ◽  
Early Warning Score ◽  
Rate Score ◽  
Level Of Consciousness ◽  
National Early Warning Score ◽  
Hospital Cardiac Arrest

In Hospital Cardiac Arrest (IHCA) is fairly common occurrence, although it can be prevented. Physiological status monitoring at Emergency Departement (ED) is crucial for early detection of potential IHCA incidence. National Early Warning Score (NEWS) is a scoring system to assess deterioration of patient's condition, but it is not yet known which parameters that have predictive value for IHCA incidence. Examine NEWS parameters of the patients while at the ED that have predictive value of IHCA incidence. This study was conducted retrospectively on inpatient medical records. The NEWS parameters examined were respiration rate score, oxygen saturation score, body temperature score, systolic blood pressure score, pulse rate score and level of consciousness score. Logistic regression analysis was used to test the predictive ability of NEWS parameters. Total score NEWS proved to be correlated with IHCA incidence (p=0.000; r=0.434). Parameters that have predictive value are systolic blood pressure score (p=0.001; OR=14.730), respiration rate score (p=0.000; OR=14.483) and level of consciousness score (p=0.000; OR=6.920). The NEWS parameter when the patients will be transferred from ED to the wards that have predictive value for IHCA incidence are systolic blood pressure score, respiration rate score and level of consciousness score.

scholarly journals Inability to Walk Predicts Death among Adult Patients in Hospitals in Malawi

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Raphael Kazidule Kayambankadzanja ◽  
Carl Otto Schell ◽  
Grace Nsanjama ◽  
Isaac Mbingwani ◽  
Samson Kwazizira Mndolo ◽  
...  
Keyword(s):  
Predictive Value ◽  
Vital Signs ◽  
Predictive Performance ◽  
Early Warning Score ◽  
Walking Ability ◽  
Patient Death ◽  
Predictive Values ◽  
Risk Of Death ◽  
Close Observation ◽  
National Early Warning Score

Objective. Vital signs are often used in triage, but some may be difficult to assess in low-resource settings. A patient’s ability to walk is a simple and rapid sign that requires no equipment or expertise. This study aimed to determine the predictive performance for death of an inability to walk among hospitalized Malawian adults and to compare its predictive value with the vital signs-based National Early Warning Score (NEWS). Methods. It is a prospective cohort study of adult in-patients on selected days in two hospitals in Malawi. Patients were asked to walk five steps with close observation and their vital signs were assessed. Sensitivities, specificities, and predictive values for in-patient death of an inability to walk were calculated and an inability to walk was compared with NEWS. Results. Four-hundred and forty-three of the 1094 participants (40.5%) were unable to walk independently. In this group, 70 (15.8 %) died in-hospital compared to 16 (2.5%) among those who could walk: OR 7.4 (95% CI 4.3-13.0 p<0.001). Inability to walk had a sensitivity for death of 81.4%, specificity of 63.0%, positive predictive value (PPV) of 15.8%, and negative predictive value (NPV) of 97.5%. NEWS>6 had sensitivity 70.9%, specificity 70.6%, PPV 17.1%, and NPV 96.6%. An inability to walk had a fair concordance with NEWS>6 (kappa 0.21). Conclusion. Inability to walk predicted mortality as well as NEWS among hospitalized adults in Malawi. Patients who were able to walk had a low risk of death. Walking ability could be considered an additional vital sign and may be useful for triage.

scholarly journals Use of a modified early warning score system to reduce the rate of in-hospital cardiac arrest

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Isao Nishijima ◽  
Shouhei Oyadomari ◽  
Shuuto Maedomari ◽  
Risa Toma ◽  
Chisato Igei ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Early Warning ◽  
Early Warning Score ◽  
Score System ◽  
Hospital Cardiac Arrest

What is optimal blood pressure in patients initially surviving an out-of-hospital cardiac arrest event?

Resuscitation ◽  
2013 ◽  
Vol 84 ◽  
pp. S83
Author(s):  
Janet Bray ◽  
Kate Cantwell ◽  
Stephen Bernard ◽  
Michael Stephenson ◽  
Karen Smith
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Optimal Blood Pressure ◽  
Hospital Cardiac Arrest

scholarly journals Using a Local Early Warning Scoring System as a Model for the Introduction of a National System

2012 ◽  
Vol 11 (2) ◽  
pp. 66-73
Author(s):  
Charlotte Austen ◽  
◽  
Caroline Patterson ◽  
Alan Poots ◽  
Stuart Green ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Early Warning ◽  
Early Warning Score ◽  
Physiological Data ◽  
Convenience Sample ◽  
Assessment Unit ◽  
Conscious Level ◽  
Potential Failure ◽  
National Early Warning Score ◽  
And Training

Background: Chelsea and Westminster Hospital introduced the Chelsea Early Warning Score (CEWS) in 2007 to aid the recognition of acutely unwell patients. The Royal College of Physicians subsequently recommended a National Early Warning Score (NEWS) for implementation across the NHS. The aim of this study was to evaluate local adherence to CEWS to identify potential obstacles to the consistent implementation of NEWS. Method: Emergency Department (ED) and Acute Assessment Unit (AAU) notes were retrospectively reviewed for a convenience sample of 102 patients admitted to the AAU. Outcome measures were completeness of documentation of CEWS parameters, documentation and accuracy of aggregate CEWS scores. Aggregate NEWS scores were calculated from the documented observations and the calculated CEWS and NEWS scores were compared. Results: Physiological observations were documented for all patients attending the ED and AAU. Heart rate, blood pressure, respiratory rate, oxygen saturation and conscious level were documented in over 95% of ED and AAU patients. Urine output was recorded for only 48% of ED and 69% of AAU patients. Aggregate CEWS scores were documented for 66% of ED and 84% of AAU patients. These were calculated accurately in 73% of ED and 79% of AAU patients. Calculation errors were eleven times more likely to result in under-scoring than over-scoring. NEWS scores were significantly higher than CEWS for the same observations and would have resulted in a 71% increase in patients requiring escalation of care in the ED and a 116% increase in AAU. Conclusion: Concerns highlighted with CEWS were the incomplete and inaccurate recording of aggregate scores, with underscoring resulting in the potential failure to recognise deteriorating patients. It is anticipated that NEWS will be accompanied by standardised documentation and training across the NHS which will support more complete and accurate recording of physiological data. Furthermore, NEWS appears from this study to be more sensitive than CEWS, thereby minimising the chance of missed deterioration.

Sign in / Sign up

Export Citation Format

Share Document