Can I Discharge This Adult Patient with Abnormal Vital Signs From the Emergency Department?

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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Abstract

Background

Vital signs are an essential component of the emergency department (ED) assessment. Vital sign abnormalities are associated with adverse events in the ED setting and may indicate a risk of poor outcomes after ED discharge.

Clinical question

What is the risk of adverse events among adult patients with abnormal vital signs at the time of ED discharge?

Evidence review

Studies retrieved included 6 retrospective studies with adult patients discharged from the ED. These studies evaluated adverse outcomes in adult patients discharged from the ED with abnormal vital signs. Hypotension at discharge was associated with the highest odds of adverse events after discharge. Tachycardia was also a key predictor of adverse events after discharge and may be easily missed by ED clinicians.

Conclusion

Based on the available evidence, the specific vital sign abnormality and the number of total abnormalities influence the risk of adverse outcomes after discharge. Vital sign abnormalities at the time of discharge also increase the risk of ED revisit. The most common abnormal vital sign at the time of discharge is tachycardia.

我可以让这位生命体征异常的成人患者从急诊科出院吗?
背景生命体征是急诊科(ED)评估的重要组成部分。临床问题急诊科出院时生命体征异常的成人患者发生不良事件的风险有多大?证据回顾检索到的研究包括 6 项针对急诊科出院成人患者的回顾性研究。这些研究评估了急诊室出院时生命体征异常的成人患者的不良后果。出院时出现低血压与出院后发生不良事件的几率最高。心动过速也是预测出院后不良事件的一个关键因素,急诊科临床医生可能很容易漏诊。结论根据现有证据,特定生命体征异常和异常总数会影响出院后不良后果的风险。出院时生命体征异常也会增加急诊室再次就诊的风险。出院时最常见的生命体征异常是心动过速。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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