UMEM Educational Pearls

Title: Abnormal vital signs, ED discharge, and adverse events

Category: Med-Legal

Keywords: adverse event, vital signs, tachycardia, hypotension (PubMed Search)

Posted: 9/6/2024 by Robert Flint, MD (Updated: 9/7/2024)
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This review reminds us that discharging emergency department patients with abnormal vital signs is a risk for the patient and the provider. The more abnormal vital signs that are present, the higher the risk of adverse event and subsequent return to the emergency department. 

“Hypotension at discharge was associated with the highest odds of adverse events after discharge. Tachycardia was also a key predictor of adverse events after discharge and may be easily missed by ED clinicians.”

Always address abnormal vital signs in your medical decision making portion of the chart and be very wary of discharging anyone with tachycardia or other abnormal vital signs.

References

Can I Discharge This Adult Patient with Abnormal Vital Signs From the Emergency Department?

Long, Brit et al. Journal of Emergency Medicine, Volume 0, Issue 0 Articles in Press May 18, 2024  DOI: 10.1016/j.jemermed.2024.05.009