All Journals from Adrian Jennings
Identification, escalation and clinical review of the deteriorating patient is essential for a safe and effective hospital. We present a deteriorating patient pathway developed within our electronic patient record, including implementation of a digital escalation and senior review process, triggered from a logic algorithm and vital signs. The pathway is activated by an average 43 patients per day with median mortality of 13.3%. Our Trust has seen a significant improvement in escalation and senior review and increased use of treatment escalation plans. The pathway has facilitated a cultural shift in the Trust towards the deteriorating patient. The new pathway is transferrable to both other digital Trusts as well as maternity and paediatric practice.
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A 47 year old Chinese businessman was found unconscious at home following an overdose of 280 mg temazepam. He was found by his sister who had visited because he had not returned her telephone calls for several weeks. He had been resident in England for 8 years but returned to Hong Kong frequently. Since his last visit to Hong Kong, 4 months previously, his mood had been low and he had developed anorexia, weight loss and insomnia. Physical examination and routine investigations were unremarkable and a diagnosis of depression was made. Citalopram 10 mg daily and temazepam 10 mg daily had been prescribed one day prior to admission.
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