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Korean J Crit Care Med > Volume 27(3); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(3): 151-156. doi: https://doi.org/10.4266/kjccm.2012.27.3.151
일개 종합병원의 조기대응팀의 활동에 사용되는 스크리닝 시스템의 유용성
울산대학교 의과대학 서울아산병원 호흡기내과학교실, *인제대학교 의과대학 부산백병원 중환자의학 및 호흡기내과학교실, †울산대학교 의과대학 서울아산병원 중환자의학교실
Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital
Hyejin Joo, So Hee Park, Sang Bum Hong, Chae Man Lim, Younsuck Koh, Young Seok Lee, Jin Won Huh
1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jwhuh@amc.seoul.kr
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
3Department of Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
BACKGROUND: Rapid response team (RRT) is becoming an essential part of patient safety by the early recognition and management of patients on general hospital wards. In this study, we analyzed the usefulness of screening criteria of RRT used at Asan Medical Center. METHODS: On a retrospective basis, we reviewed the records of 675 cases in 543 patients that were managed by RRT (called medical alert team in the Asan Medical Center), from July 2011 to December 2011. The medical alert team was acted by requests of attending doctors or nurses or the medical alert system (MAS) criteria composed of abnormal vital sign, neurology, laboratory data and increasing oxygen demand. We investigated the patterns of MAS criteria for targeting the patients who were managed by the medical alert team. RESULTS: Respiratory distress (RR > 25/min) was the most common item for identifying patients whose condition had worsened. The criteria consist with respiratory distress and abnormal blood pressure (mean BP < 60 mmHg or systolic BP < 90 mmHg) found 70.0% of patients with deteriorated conditions. Vital sign (RR > 25/min, mean BP < 60 mmHg or systolic BP < 90 mmHg, pulse rate, PR > 130/min or < 50/min) and oxygen demand found 79.2% of them. Vital signs, arterial blood gas analysis (ABGA) with lactate level (pH, pO2, pCO2, and lactate) and O2 demand found 98.6% of patient conditions had worsened. CONCLUSIONS: Vital signs, especially RR > 25/min is useful criteria for detecting patients whose conditions have deteriorated. The addition of ABGA data with lactate levels leads to a more powerful screening tool.
Key Words: hospital rapid response team; MAS screening; standards; woren patients
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