Physiological deterioration in the Emergency Department: The SNAP40-ED study
Continuous novel ambulatory monitoring may detect deterioration in Emergency Department (ED) patients more rapidly, prompting treatment and preventing adverse events. Single-centre, open-label, prospective, observational cohort study recruiting high/medium acuity (Manchester triage category 2 and 3)...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2021-09-01
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| Series: | Emergency Care Journal |
| Subjects: | |
| Online Access: | https://pagepressjournals.org/index.php/ecj/article/view/9711 |
| _version_ | 1828410109783441408 |
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| author | Matthew J. Reed Rachel O'Brien Polly L. Black Steff Lewis Hannah Ensor Matt Wilkes Christopher McCann Stewart Whiting |
| author_facet | Matthew J. Reed Rachel O'Brien Polly L. Black Steff Lewis Hannah Ensor Matt Wilkes Christopher McCann Stewart Whiting |
| author_sort | Matthew J. Reed |
| collection | DOAJ |
| description | Continuous novel ambulatory monitoring may detect deterioration in Emergency Department (ED) patients more rapidly, prompting treatment and preventing adverse events. Single-centre, open-label, prospective, observational cohort study recruiting high/medium acuity (Manchester triage category 2 and 3) participants, aged over 16 years, presenting to ED. Participants were fitted with a novel wearable monitoring device alongside standard clinical care (wired monitoring and/or manual clinical staff vital sign recording) and observed for up to 4 hours in the ED. Primary outcome was time to detection of deterioration. Two-hundred and fifty (250) patients were enrolled. In 82 patients (32.8%) with standard monitoring (wired monitoring and/or manual clinical staff vital sign recording), deterioration in at least one vital sign was noted during their four-hour ED stay. Overall, the novel device detected deterioration a median of 34 minutes earlier than wired monitoring (Q1, Q3 67,194; n=73, mean difference 39.48, p<0.0001). The novel device detected deterioration a median of 24 minutes (Q1, Q3 2,43; n=42) earlier than wired monitoring and 65 minutes (Q1, Q3 28,114; n=31) earlier than manual vital signs. Deterioration in physiology was common in ED patients. ED staff spent a significant amount of time performing observations and responding to alarms, with many not escalated. The novel device detected deterioration significantly earlier than standard care. |
| first_indexed | 2024-12-10T12:05:53Z |
| format | Article |
| id | doaj.art-9b34dc6e071e4be880af4ab354b81755 |
| institution | Directory Open Access Journal |
| issn | 1826-9826 2282-2054 |
| language | English |
| last_indexed | 2024-12-10T12:05:53Z |
| publishDate | 2021-09-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Emergency Care Journal |
| spelling | doaj.art-9b34dc6e071e4be880af4ab354b817552022-12-22T01:49:28ZengPAGEPress PublicationsEmergency Care Journal1826-98262282-20542021-09-0117310.4081/ecj.2021.9711Physiological deterioration in the Emergency Department: The SNAP40-ED studyMatthew J. Reed0Rachel O'Brien1Polly L. Black2Steff Lewis3Hannah Ensor4Matt Wilkes5Christopher McCann6Stewart Whiting7Emergency Medicine Research Group Edinburgh (EMERGE), Department of Emergency Medicine, Royal Infirmary of Edinburgh; Acute Care Group, Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of EdinburghEmergency Medicine Research Group Edinburgh (EMERGE), Department of Emergency Medicine, Royal Infirmary of EdinburghEmergency Medicine Research Group Edinburgh (EMERGE), Department of Emergency Medicine, Royal Infirmary of EdinburghEdinburgh Clinical Trials Unit, Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, EdinburghEdinburgh Clinical Trials Unit, Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, EdinburghCurrent Health (formerly SNAP40), Playfair House, 6 Broughton St Ln, Edinburgh EH1 3LYCurrent Health (formerly SNAP40), Playfair House, EdinburghCurrent Health (formerly SNAP40), Playfair House, EdinburghContinuous novel ambulatory monitoring may detect deterioration in Emergency Department (ED) patients more rapidly, prompting treatment and preventing adverse events. Single-centre, open-label, prospective, observational cohort study recruiting high/medium acuity (Manchester triage category 2 and 3) participants, aged over 16 years, presenting to ED. Participants were fitted with a novel wearable monitoring device alongside standard clinical care (wired monitoring and/or manual clinical staff vital sign recording) and observed for up to 4 hours in the ED. Primary outcome was time to detection of deterioration. Two-hundred and fifty (250) patients were enrolled. In 82 patients (32.8%) with standard monitoring (wired monitoring and/or manual clinical staff vital sign recording), deterioration in at least one vital sign was noted during their four-hour ED stay. Overall, the novel device detected deterioration a median of 34 minutes earlier than wired monitoring (Q1, Q3 67,194; n=73, mean difference 39.48, p<0.0001). The novel device detected deterioration a median of 24 minutes (Q1, Q3 2,43; n=42) earlier than wired monitoring and 65 minutes (Q1, Q3 28,114; n=31) earlier than manual vital signs. Deterioration in physiology was common in ED patients. ED staff spent a significant amount of time performing observations and responding to alarms, with many not escalated. The novel device detected deterioration significantly earlier than standard care.https://pagepressjournals.org/index.php/ecj/article/view/9711Ambulatory monitoringMonitoringphysiologicalPatient monitoringClinical deterioration |
| spellingShingle | Matthew J. Reed Rachel O'Brien Polly L. Black Steff Lewis Hannah Ensor Matt Wilkes Christopher McCann Stewart Whiting Physiological deterioration in the Emergency Department: The SNAP40-ED study Emergency Care Journal Ambulatory monitoring Monitoring physiological Patient monitoring Clinical deterioration |
| title | Physiological deterioration in the Emergency Department: The SNAP40-ED study |
| title_full | Physiological deterioration in the Emergency Department: The SNAP40-ED study |
| title_fullStr | Physiological deterioration in the Emergency Department: The SNAP40-ED study |
| title_full_unstemmed | Physiological deterioration in the Emergency Department: The SNAP40-ED study |
| title_short | Physiological deterioration in the Emergency Department: The SNAP40-ED study |
| title_sort | physiological deterioration in the emergency department the snap40 ed study |
| topic | Ambulatory monitoring Monitoring physiological Patient monitoring Clinical deterioration |
| url | https://pagepressjournals.org/index.php/ecj/article/view/9711 |
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