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Does earlier detection of critically ill patients on surgical wards lead to better outcomes?

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Does earlier detection of critically ill patients on surgical wards lead to better outcomes?

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INTRODUCTION: Patients at risk of catastrophic deterioration are often identified too late. Delayed identification of sick patients and delayed referral to intensive care units might be associated with poor outcomes. The goal of the review is to assess the potential impact of systems that enable early detection of critically ill surgical patients. MATERIALS AND METHODS: A Medline search was performed in September 2004. Other articles were identified using the bibliographies of papers found through Medline. All interventional trials reviewing the effect of Critical Care Outreach and Medical Emergency Teams were reviewed. RESULTS: There is evidence that simple algorithms based on bedside observations can identify a large proportion of sick patients on general wards. Non-randomised studies have shown mixed results on impact of these interventions on mortality, cardiopulmonary arrests and intensive care admissions. The majority of studies do not specifically address surgical patients. A wa

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