• Esteban Araos-Baeriswyl, Teo Feuerhake, Manuel Mundaca, Bárbara Lara, Francisco Ortega, Nicolás Aeschlimann, and Gonzalo Eymin.
• Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
• Rev Med Chil. 2018 Sep 1; 146 (9): 1024-1027.

BackgroundMedical emergencies (ME) in hospitalized patients (cardiac and respiratory arrest, suffocation, asphyxia, seizures, unconsciousness) are associated with high morbidity and mortality. Most of these patients have signs of physiological deterioration prior to the appearance of the emergency. Early detection of warning signs by rapid response teams (RRT) may provide an opportunity for the prevention of major adverse events.AimTo identify clinical signs predicting death, need for mechanical ventilation, or transfer to a more complex unit during the 72 hours prior to the activation of the ME code. To evaluate the association of each trigger with specific major adverse events.Patients And MethodsMedical records of 184 hospitalized adult patients in whom the ME code was activated between 2009 and 2014 were reviewed.ResultsSeventy five percent patients who experienced a ME had predictive signs of poor clinical outcome. Polypnea and airway involvement were associated to mechanical ventilation. Hypotension and hypoxemia were associated with mortality.ConclusionsIn the absence of RRT, special attention should be given to patients with polypnea, airway involvement, hypotension and desaturation, since these are associated with poor clinical outcomes.

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