title: Hopeful waiting: positive outcome of blood pressure monitoring in an emergency department.
abstract: Hospitals use a triage system in which health care staff sort's patients into groups. During the long waiting periods after triage, inadvertence of patient's clinical deterioration may occur.
  
  
  OBJECTIVE
  To determine whether vital signs and oxygen saturation monitoring and reassessment of medical priority during the waiting period had a positive impact on the clinical outcome of apparently non-critical patients.
  
  
  METHODS
  The study was undertaken in a University Hospital Emergency Department (ED). Patients were sorted into experimental (group A) and control (group B) groups. Temperature, respiratory and pulse rates readings of group A patients were constantly generated by electronic devices and displayed in a computer screen. The results were checked every 5-to-10 minutes. Blood pressure (BP) and oxygen (02) saturation were verified every 30 minutes. If critical changes occurred, the patient's chart was discretely moved to the top of the waiting pile. Group B patients were not monitored. Clinical outcome (complications, stability of vital signs, and complete resolution of symptoms at discharge) and the length of hospital stay were compared for both groups.
  
  
  RESULTS
  Patients in group A had a shorter hospital stay (p<0.0001), lower rate of complications (p=0.003), and higher rate of vital sign stability (p<0.0001) and of complete resolution of symptoms at discharge (p<0.0001).
  
  
  CONCLUSIONS
  Blood pressure monitoring every 30 minutes significantly improved ED waiting patients' clinical outcome and shortened their hospital stay. Observations of oxygen saturation, temperature, pulse, and respiratory rate were not significantly useful.
authors.affiliation: Department of Internal Medicine, Dr. Ramón Ruiz Arnau University Hospital, Universidad Central del Caribe, School of Medicine, Bayamón, Puerto Rico. yiduate2000@yahoo.com
authors.forename: Wilfredo Eddy
authors.initials: WE
authors.lastname: Bravo Llerena
authors.forename: David
authors.initials: D
authors.lastname: Claudio
authors.forename: José
authors.initials: J
authors.lastname: Ramírez Rivera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D057832:Watchful Waiting; D055815:Young Adult