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The seriously ill or deteriorating patient 

The seriously ill or deteriorating patient
The seriously ill or deteriorating patient

Carole Foot

, and Liz Hickson

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date: 07 March 2021

The first step in the clinical approach to a patient who is very ill is the recognition of this fact. While experienced clinicians will intuitively recognize a seriously ill or deteriorating patient, a large body of data has demonstrated that warning signs are often missed or not acted upon, resulting in preventable harm to patients. This has led to the development and adoption of ‘track and trigger’ systems. Track and trigger systems aim to ensure that hospitalized patients undergo regular review and objective observation, with abnormal observation or staff concerns being triggers to escalate care. Escalated care may be urgent review by the treating team, or the calling of a ‘rapid response team’ to attend to a more critically ill patient. While calling criteria and team composition varies from country to country, the principle of rapidly taking skilled care to critically ill patients remains the unifying underlying principle.

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