Vital signs - L'Infirmière Magazine n° 269 du 15/12/2010 | Espace Infirmier
 

L'infirmière Magazine n° 269 du 15/12/2010

 

ANGLAIS

Vital signs monitoring plays a crucial role in helping nurses prevent worsening clinical situations becoming crises. In order to be valuable tools, the four physiological readings (systolic blood pressure, heart rate, respiratory rate and body temperature) must be correctly measured, recorded and interpreted. Inaccurate and misinterpreted information can compromise timely interventions for deteriorating patients and have fatal results.

Solutions proposed to improve the accuracy of vital signs monitoring include the MEWS system(1). The Modified Early Warning Score takes the reading of vital signs along with a level of consciousness observation to produce a score that identifies patients at risk of deterioration. The MEWS system is an example of a track and trigger system, whereby the tracking of data results in the triggering of an action. In some circumstances, trends towards deterioration and instability may be difficult to detect and vital signs perhaps not the best indicators. Another index, called the Shock Index (SI), may be an accurate and simple alternative(2). The SI uses heart rate divided by systolic blood pressure as an indicator of left ventricular function, where the reference is 0.54. The SI has been shown to be useful in unplanned, unexpected transfers from general medical wards to ICU wards where the SI value is greater than 0.85.

Sources : « Vital Signs », Louise Rose, American Journal of Nursing, May 2010, Volume 110, Issue 5, p 11.

« The Signs are all there », Rosalind Brown, Nursing Standard, vol. 23, n° 42, p. 61, June 24, 2010.

MOTS ET EXPRESSIONS

Worsening (n) évolution défavorable ; aggravation

Reading (n) indicateur ; relevé de données

Heart/respira-tory rate (n) fréquence cardiaque/respiratoire

Track and trigger (n) de suivi et d’alerte

ICU ward (n) service de soins intensifs

QUESTIONS

1. What are the consequences of inaccurate and misinterpreted vital signs ?

Timely interventions may be compromised ; consequences may be fatal.

2. What are the MEWS and SI systems used for ?

They improve the accuracy of vital signs monitoring in order to detect trends towards deterioration.

3. Explain « track and trigger ».

One checks the trend of data and, at a certain value, puts an action in place.

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