ASSESSMENT OF PHYSIOLOGICAL PARAMETERS AMONG CRITICALLY ILL PATIENTS IN INTENSIVE CARE UNIT, AT TERTIARY CARE HOSPITAL, KODAGU”-AN OBSERVATIONAL STUDY
DOI:
https://doi.org/10.65009/fxv3sh30Keywords:
MEWS score, Temperature, Pulse rate, Respiratory rate, Systolic blood pressure, Oxygen saturation, critically ill patients.,,Abstract
Background of the Study: Intensive care units (ICUs) are dedicated for enhancing the survival
of critically ill patients and require constant monitoring due to life threatening conditions. Vital
signs is a cardinal indicator of a patient's health status. Modified Early Warning Score
(MEWS), a scoring system based on vital signs, helps standardize patient assessment and
allows for early recognition of patient’s delicate distinctions, prompting appropriate escalation
of care.
Aim: To find out the association of physiological parameters with selected socio- demographic
variables and selected clinical variables among critically ill patients.
Methods: An observational study using a descriptive approach was conducted to assess the
physiological parameters among (n=140) critically ill patients. Data was collected using
sociodemographic, clinical variables and physiological variables were recorded using MEWS
score from cardiac monitor. Participants were selected using convenience sampling method
who were admitted in ICUs at tertiary care hospital, Madikeri between January 2025 to
February 2025. Data was analyzed and interpreted by applying descriptive and inferential
statistical methods
Results: In this study, out of 140 respondents 39(27.9%) of patients showed a MEWS scoring
of 3-4 indicating the critically ill patients require continuous observation and monitoring in
order to prevent further complications. Also 47(33.6%) of patients were showing signs of
respiratory failure (MEWS ≥ 5) which indicated higher level of care
On the other hand, it is observed that there is a significant association between oxygen
saturation (%) with age (χ2=8.192, p=0.042), temperature(0c) with gender (χ2=4.726, p=0.030),
systolic blood pressure(mmHg) with monthly family income ((χ2=8.35, p=0.039) at 0.05 level
of significance. There is also significant association between respiratory rate(breaths/min) with
GCS category (χ2=6.542, p=0.038) and critically ill category (χ2=13.524, p=0.001), systolic
blood pressure(mmHg) with patients on regular medication use (χ2=5.040, p=0.025) at 0.05
level of significance.
Conclusion: MEWS is a simple, physiological score to prevent delay in intervention or transfer
of critically ill patients. It is an important risk management tool that should be implemented
for all ICU patients
References
Nates et al (2016). ICU admission, discharge, and triage guidelines: a framework to
enhance clinical operations, development of institutional policies, and further research.
Crit Care Med,44(8),1553-602.DOI: 10.1097/CCM.0000000000001856
to
Bassford C(2017). Decisions regarding admission to the ICU and international
initiatives
improve the decision-making process. Critical Care,21,174.
DOI:10.1186/s13054-017-1749-3
from
S.J. Lloyd-Owen et al(2005). Patterns of home mechanical ventilation use in Europe:
results
the
Eurovent
survey.
Eur
Respir
J,25,025–1031.DOI:
1183/09031936.05.00066704
Suresh K Sharma ,Ritu Rani(2020). Nurse-to-patient ratio and nurse staffing norms for
hospitals in India: A critical analysis of national benchmarks, J Family Med Prim
Care,9(6), 2631–2637. doi: 10.4103/jfmpc.jfmpc_248_20.
Kumar Tirupakuzhi Vijayaraghavan et al(2021). Challenges in the delivery of critical
care in India during the COVID-19 pandemic. J Intensive Care Soc, 22(4),342-348.
doi:10.1177/1751143720952590.
Swaminathan N, Praveen R, Surendran P (2019). The role of physiotherapy in
intensive care units: a critical review. Physiotherapy Quarterly, 27(4),1-5.
DOI:10.5114/pq.2019.8773
Stenhouse et.al(2000). Prospective evaluation of a modified Early Warning Score to aid
earlier detection of patients developing critical illness on a general surgical ward. Br J
Anaesth,84(5),663. DOI: 10.1093/bja/84.5.663
Subbe CP, Kruger M, Rutherford P, Gemmel L(2001). Validation of a modified Early
Warning
Score
in
medical
admissions.
QJMed.,94(10):521-6.doi:
1093/qjmed/94.10.521.
.
J Gardner et.al(2006). The Value of Modified Early Warning Score (MEWS) in Surgical
In-Patients: A Prospective Observational Study. Ann R Coll Surg Engl,88(6),571-5.
doi: 10.1308/003588406X130615. PMCID: PMC1963767.
M.Bhatnagar et.al(2021). Prediction of hospital outcome in emergency medical
admissions using modified early warning score (MEWS): Indian experience. J Family
Med Prim Care.10(1),192-198. doi: 10.4103/jfmpc.jfmpc_1426_20.. PMID: 34017725;
PMCID: PMC8132807.
Ljunggren et al(2016). The association between vital signs and mortality in a
retrospective cohort study of an unselected emergency department population. Scand J
Trauma Resusc Emerg Med,24(21). https://doi.org/10.1186/s13049-016-0213
B.Sarang et.al(2021). Associations of On-arrival Vital Signs with 24-hour In-hospital
Mortality in Adult Trauma Patients Admitted to Four Public University Hospitals in
Urban India: A Prospective Multi-Centre Cohort Study. Injury, 52(5),1158-1163. doi:
1016/j.injury.2021.02.075.PMID: 33685640.
D Garrido etal (2018). Respiratory Rate Variability as a Prognostic Factor in
Hospitalized Patients Transferred to the Intensive Care Unit. Cureus, Jan
,10(1),e2100. doi: 10.7759/cureus.2100.
H Reich et al(2024). Sociodemographic, psychological, and clinical characteristics
associated with health service (non-)use for mental disorders in adolescents and young
adults from the general population. Eur Child Adolesc Psychiatry,33(2),391-400.
doi: 10.1007/s00787-023-02146-3
Patient
Prasad DVLN(2024). The Importance of Thinking in a Physiological Perspective
in
Analysis and Treatment. J Clin Biomed Sci,14(3),68-69.
https://doi.org/10.58739/jcbs/v14i3.editorial.
Arya Kulkarni, Elizabeth David, Anija Manoharan(2023). Effectiveness of
Implementation of MEWS with the help of RRS in Reducing in-Hospital Cardiac
Arrest and Code Blue in a Selected Hospital Pune City. Indian Journal of Public Health
Research and Development,10(1), January-March 2023.
View of Effectiveness of Implementation of MEWS with the help of RRS in Reducing
in-Hospital Cardiac Arrest and Code Blue in a Selected Hospital Pune City
Ursolino, G. (2019). The Association of Modified Early Warning Score on Patient
Outcomes in Medical Surgical Units in an Academic Medical Center. Retrieved from
https://hsrc.himmelfarb.gwu.edu/ son_dnp/53
Duncan KD, McMullan C, Mills BM(2012). Early warning systems: the next level
of rapid response. Nursing, 42(2),39-44.
DOI: 10.1097/01.NURSE.0000410304.26165.33
