Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units
Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units
复制标题
DOI：
10.1016/j.ijoa.2017.03.002
复制
发表时间：
2017-05-01
影响因子：
2.8
通讯作者：
Hundley, V.
中科院分区：
文献类型：
--
作者：
Smith, G. B.;Isaacs, R.;Hundley, V.
背景：产科早期预警系统被推荐用于监测住院的孕妇和产后妇女。我们决定比较一下：（一）用于定义生理正常的生命体征值;（二）症状和体征用于升级护理;（三）图表使用的类型;和（四）存在明确的指示升级care.Methods：一百二十产科预警图表和升级协议，从领事馆领导的妇产科单位在英国和海峡群岛。这些数据提取自：用于确定每个产妇生命体征的正常值;图表颜色编码;预警系统触发后的指示;用作trigger.Results的其他标准：图表、预警系统和升级协议存在相当大的差异。在120张图表中，89.2%使用了彩色; 69.2%使用了彩色编码的升级系统。41个（34.2%）系统需要计算加权评分。发现了75种“正常”生命体征范围的离散组合，最常见的是：心率=50-99次/分钟;呼吸频率=11-20次/分钟;收缩压= 100 - 149 mmHg，舒张压=100-149 mmHg;心率= 50 - 99次/分钟;呼吸频率=11-20次/分钟;收缩压=100-149 mmHg，舒张压=100-149 mmHg。
Background: Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care.Methods: One-hundred-and-twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands. These data were extracted: values used to determine normality for each maternal vital sign; chart colour-coding; instructions following early warning system triggering; other criteria used as triggers.Results: There was considerable variation in the charts, warning systems and escalation protocols. Of 120 charts, 89.2% used colour; 69.2% used colour-coded escalation systems. Forty-one (34.2%) systems required the calculation of weighted scores. Seventy-five discrete combinations of 'normal' vital sign ranges were found, the most common being: heart rate=50-99 beats/min; respiratory rate=11-20 breaths/min; blood pressure, systolic=100-149 mmHg, diastolic