aDeakin University-Northern Health Clinical Partnership, Burwood bDepartment of Intensive Care, Austin Health, Heidelberg cAustralian and New Zealand Intensive Care Research Centre, Monash University, Prahran, Victoria, Australia.
Eur J Emerg Med. 2013 Dec;20(6):375-81. doi: 10.1097/MEJ.0b013e32835d1e14.
The aim of this paper, is to present a case to develop and test emergency department (ED)-specific approaches to improve the sequential detection, recognition and timely escalation of care for ED patients who have deteriorated after their initial triage and assessment.
Managing the risk of clinical deterioration is a key feature of emergency care and underpins practice. However, although the epidemiology of deterioration in hospitalized ward patients has been well studied, the epidemiology of deterioration in ED patients is less understood. As ED workloads continue to increase, an emerging challenge for ED clinicians is how best to recognize and rapidly respond to deteriorating ED patients following triage and/or medical assessment. Rapid response systems for such patients exist in hospital wards; however, the use of rapid response systems in EDs is variable and largely unknown outside the UK.
A systematic approach to the early recognition of, and response to, deteriorating ED patients across the entire ED trajectory of care remains untested. Given the complexities of the ED environment, ward-based models of recognizing and responding to deteriorating patients may not meet the specific needs of the ED.
本文旨在提出一种针对急诊科（ED）的方法，以提高对初始分诊和评估后病情恶化的 ED 患者的连续检测、识别和及时升级护理的能力。
管理临床恶化的风险是急诊护理的一个关键特征，也是实践的基础。然而，尽管已经对住院病房患者的恶化流行病学进行了很好的研究，但对 ED 患者的恶化流行病学了解较少。随着 ED 工作量的不断增加，ED 临床医生面临的一个新挑战是如何在分诊和/或医疗评估后最好地识别和快速应对恶化的 ED 患者。针对此类患者的快速反应系统在医院病房中已经存在；然而，在英国以外，ED 中使用快速反应系统的情况各不相同，而且知之甚少。
针对整个 ED 护理轨迹中病情恶化的患者的早期识别和反应的系统方法仍有待检验。鉴于 ED 环境的复杂性，基于病房的识别和应对恶化患者的模式可能无法满足 ED 的特定需求。
