The value of the Modified Early Warning Score for unplanned Intensive Care Unit admissions of patients treated in hospital general wards.

AIM: To determine the value of the Modified Early Warning Score (MEWS) for general ward patients and its potential use as an alarm tool for ward nurses. METHODS: A combined prospective-retrospective observational study was conducted with 153 patients in a university hospital (2013-2014). All patients were admitted to the intensive care unit (ICU) from general wards. Parameters retrospectively studied were 5 MEWS values at 4 hourly intervals, up to 20 hours before ICU admission. Parameters prospectively studied were ICU length of stay, ICU mortality, and mortality after ICU discharge. RESULTS: Most frequent severe adverse events were acute respiratory failure (39.9%) and septic shock (20.3%). Modified Early Warning Score increased gradually during the last 20 hours, and most patients remained in the wards, above a cut-off point ≥7 recorded at 4 hours before admission. Significant associations between latest MEWS score and ICU mortality and ICU length of stay were found. MEWS score≥ 7 hours before admission was highly associated with increased ICU and hospital mortality. CONCLUSION: Patient deterioration in general wards can result in severe adverse events. Modified Early Warning Score is a strong predictor of outcome and may be used as a monitoring tool for potentially avoidable deaths and unplanned admissions to ICU.

Basic life support skill retention by medical students: a comparison of two teaching curricula.

AIM: In December 2005 the new guidelines for resuscitation were released and a new curriculum for the teaching of basic life support (BLS) was adopted. The aim of the present study was to investigate the effectiveness of the new guidelines and teaching curriculum on the BLS skill retention of medical students 1 year following their initial training. METHODS: The study was conducted in two consecutive academic years and compared BLS skill retention of two groups of medical students in their fourth year of medicine. The first group (group A) was taught the old guidelines with the old curriculum in the year 2005 and was re-assessed in 2006, and the second group (group B) was taught the new guidelines with the new curriculum in the year 2006 and was re-assessed in 2007. RESULTS: Significantly more students in group B assessed signs of life, located the compression area correctly and performed good quality chest compressions compared with the group taught the old guidelines with the old curriculum. CONCLUSIONS: The most important BLS skill, good quality chest compressions, was retained by significantly more students who were taught the new resuscitation guidelines according to the new curriculum.