#32 Early Detection of Clinical Deterioration

Signs of clinical deterioration often start appearing hours before an adverse event or arrest. As nurses, we are in the unique position to be able to identify and act on early warning signs. Nurse Alice, from the Ask Nurse Alice podcast, talks about early signs and symptoms of clinical deterioration and how the Modified Early Warning Score (MEWS) can be implemented.

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About the Guest: Nurse Alice

Alice Benjamin is a board-certified Clinical Nurse Specialist and Family Nurse Practitioner with over 23 years nursing experience specializing in cardiovascular and critical care.

he is a national lecturer and social media influencer who presents workshops on various health, wellness, and motivational topics to companies and organizations.

She is a recurring on-air health medical contributor for NBC 4 in Los Angeles and has appeared as a regular for other local and national news networks.  

She hosts the podcast Ask Nurse Alice.

Episode Take-Aways

  • Early Warning Scores, sometimes called Modified Early Warning Scores (MEWS) are used by institutions as an object indicator of early deterioration. Determinants include: BP, HR, RR, temp, and LOC
  • RR is an early indicator of clinical deterioration. Take the time up front to count respirations as this could potentially safe you and your patient from an RRT later.
  • SpO2 is a measurement of oxygenation and often lags. SpO2 does not give a full picture of the patient’s respiratory status.
  • Capnography is a measurement of ventilation and gives you relevant real-time data

A meta-analysis of eight prospective studies indicates that respiratory depression is 28 times more likely to be detected if patients are monitored by capnography when compared with controls who weren’t” (D’Arcy, 2013)

  • Listen to loved ones. They know the patient best
  • It’s OK to wake your patient up to assess them