일개 종합병원의 조기대응팀의 활동에 사용되는 스크리닝 시스템의 유용성 (Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital)

서지정보

· 발행기관 : 대한중환자의학회
· 수록지 정보 : Acute and Critical Care / 27권 / 3호 / 151 ~ 156페이지
· 저자명 : 주혜진, 박소희, 홍상범, 임채만, 고윤석, 이영석, 허진원

초록

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.

영어초록

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.

참고자료

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