Acutely ill adults in hospital: recognising and responding to deterioration

Reasons for the decision

Topic experts suggested key areas to focus on in this surveillance review, including the use of track and trigger/early warning systems in the recognition of patient deterioration, electronic compared with paper-based systems for recognition of patient deterioration, and response strategies for patients identified as experiencing clinical deterioration (for reasons including changes in policy and their view of possible new evidence). Focused searches for new evidence were undertaken in these areas as part of this surveillance review. Evidence we identified was either consistent with current recommendations or was not considered sufficient to impact on the recommendations in this guideline. Evidence allowing direct comparisons between different track and trigger tools/early warning scores or between different response strategies was limited. Overall, the new evidence that was identified was not considered to impact on the recommendations in this guideline.

We identified ongoing research on the use of early warning scales and monitoring of vital signs. The publication status of these studies and any potential impact on guideline recommendations upon publication will be monitored.

The use of early warning scores in the assessment of people with suspected sepsis is covered by the NICE guideline on sepsis: recognition, diagnosis and early management.

For further details and a summary of all evidence identified in surveillance, see appendix A.