Hopeful waiting: positive outcome of blood pressure monitoring in an emergency department
Bravo Llerena, W.Eddy.; Claudio, D.; Ramírez Rivera, Jé.
Boletin de la Asociacion Medica de Puerto Rico 103(3): 18-22
2011
ISSN/ISBN: 0004-4849 PMID: 23210328 Document Number: 702455
Hospitals use a triage system in which health care staff sort's patients into groups. During the long waiting periods after triage, inadvertence of patient's clinical deterioration may occur. To determine whether vital signs and oxygen saturation monitoring and reassessment of medical priority during the waiting period had a positive impact on the clinical outcome of apparently non-critical patients. The study was undertaken in a University Hospital Emergency Department (ED). Patients were sorted into experimental (group A) and control (group B) groups. Temperature, respiratory and pulse rates readings of group A patients were constantly generated by electronic devices and displayed in a computer screen. The results were checked every 5-to-10 minutes. Blood pressure (BP) and oxygen (02) saturation were verified every 30 minutes. If critical changes occurred, the patient's chart was discretely moved to the top of the waiting pile. Group B patients were not monitored. Clinical outcome (complications, stability of vital signs, and complete resolution of symptoms at discharge) and the length of hospital stay were compared for both groups. Patients in group A had a shorter hospital stay (p<0.0001), lower rate of complications (p=0.003), and higher rate of vital sign stability (p<0.0001) and of complete resolution of symptoms at discharge (p<0.0001). Blood pressure monitoring every 30 minutes significantly improved ED waiting patients' clinical outcome and shortened their hospital stay. Observations of oxygen saturation, temperature, pulse, and respiratory rate were not significantly useful.
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