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Early Warning Signs of Patient Deterioration

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Early Warning Signs of Patient Deterioration

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failure to rescue“Failure to rescue” is the clinical term for a delay in responding to a change in a patient’s condition. The delay may lead to death. Families with questions about the events leading up to a loved one’s death may seek a plaintiff’s attorney’s assistance in getting answers. The human costs – both to the patient and the healthcare provider, have led to efforts to hone in on the early warning signs of a deterioration in condition.

There may be as many as 6 to 8 hours of warning signs and symptoms prior to a cardiac arrest. Only about 17% of the adults who suffer a cardiac arrest in a U.S. hospital survive to be discharged.

Developed in the United Kingdom and refined in the United States, a new system quantifies the risk factors to alert health care providers of an emerging problem before the patient dies. The Early Warning Scoring System is a method of assigning points to certain changes in blood pressure, pulse, respirations, temperature, consciousness and urine output. The nurses use a specifically designed format to enter the values into a grid. Each value is assigned a point. Scores are added to create a total. The nurse takes action based on the total score, such as contacting the rapid response team.

One of the advantages of this type of scoring system is that it takes the guesswork out of what to do next. A score of a certain level can automatically result in sending a message to the head of the rapid response team or bring the team to the patient’s bedside. At Stony Brook University Medical Center, which instituted this system, some of the nurses had previously been criticized for calling the rapid response team. This type of scoring system makes the decision easier and eliminates the hesitation of the nurses.

It is vital for the nurses to call for help early before the patient has gone into arrest. Early intervention saves lives. The Early Warning System gives nurses a tool to use to get early attention for their patients.

Implications for Attorneys
It is not the facilities that use a form of an early warning system that you have to worry about. It is the hospitals that don’t, or don’t have a well developed rapid response team. A failure to rescue case may be shrouded in mystery. If the healthcare providers don’t recognize the signs of deterioration and don’t take action, the arrest may appear to be sudden. The family may be unaware that there were warning signs that were ignored, leading to a preventable death.

An astute medical professional who reviews the chart may see the patterns the providers missed.

Med League provides experts to review the events leading up to cardiac arrests. Contact us for help with your next case.

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