title: Emergency department rapid response systems: the case for a standardized approach to deteriorating patients.
abstract: OBJECTIVE
  The aim of this paper, is to present a case to develop and test emergency department (ED)-specific approaches to improve the sequential detection, recognition and timely escalation of care for ED patients who have deteriorated after their initial triage and assessment.
  
  
  RESULTS
  Managing the risk of clinical deterioration is a key feature of emergency care and underpins practice. However, although the epidemiology of deterioration in hospitalized ward patients has been well studied, the epidemiology of deterioration in ED patients is less understood. As ED workloads continue to increase, an emerging challenge for ED clinicians is how best to recognize and rapidly respond to deteriorating ED patients following triage and/or medical assessment. Rapid response systems for such patients exist in hospital wards; however, the use of rapid response systems in EDs is variable and largely unknown outside the UK.
  
  
  CONCLUSIONS
  A systematic approach to the early recognition of, and response to, deteriorating ED patients across the entire ED trajectory of care remains untested. Given the complexities of the ED environment, ward-based models of recognizing and responding to deteriorating patients may not meet the specific needs of the ED.
authors: aDeakin University-Northern Health Clinical Partnership, Burwood bDepartment of Intensive Care, Austin Health, Heidelberg cAustralian and New Zealand Intensive Care Research Centre, Monash University, Prahran, Victoria, Australia.
authors: Julie
authors: J
authors: Considine
authors: Daryl
authors: D
authors: Jones
authors: Rinaldo
authors: R
authors: Bellomo
mesh_terms: D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D042241:Early Diagnosis; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team / Q000458:organization & administration*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D061214:Patient Safety; D012015:Reference Standards; D018570:Risk Assessment; D016896:Treatment Outcome; D014218:Triage