A number of factors may contribute to a person dying unexpected following release home from the Emergency Department.
Recurrent themes reported by Sklar et al:
(1) atypical presentation of an unusual problem
(2) chronic disease with end-stage decompensation
(3) presence of abnormal vital signs (see below)
(4) mental disability, psychiatric problem and/or substance abuse (unwilling to return for worsening symptoms)
Abnormal vital signs included:
(1) pulse > 99 OR < 60 beats per minute
(2) systolic blood pressure > 179 OR < 90 mm Hg
(3) diastolic blood pressure > 109 mm Hg
(4) respiratory rate > 24 OR < 12 breaths per minute
(5) body temperature > 37.9°C (100.2°F) OR < 35°C (95°F)
(6) oxygen saturation < 90%
Additional factors might include:
(1) The patient was physically unable to return for worsening condition.
(2) There was progression of a condition not detected in the ED (like subarachnoid hemorrhage).
(3) The patient did not want to stay.
(4) The healthcare provider was inexperienced or made an error.
To read more or access our algorithms and calculators, please log in or register.
Purpose: To identify a patient in the Emergency Department (ED) who may be at increased risk for unexpected death following release.
Specialty: Clinical Laboratory
Objective: risk factors, severity, prognosis, stage, comorbid conditions