How to avoid catastrophic events on the ward

The number and disease severity of hospitalized patients have risen steadily. At the same time, the length of stay in the hospital has decreased and there is an increasing shortage of nursing staff and physicians. In order to enable a timely treatment of serious in-house emergencies (i.e., cardiac arrest and cardiopulmonary resuscitation) and to decrease the risk of unexpected deaths, early detection and treatment of critically ill patients are of paramount importance. Therefore, patients should be monitored according to their disease severity in order to detect a critical change in vital signs. Early critical incident warning systems may play a role in this context. Currently, different rapid warning systems have been established, but data that allow a choice for a certain system are still lacking. Alarm criteria based on a single variable (single-parameter system) are a simple, but less sensitive alternative to indicate a serious adverse event. Scoring systems enable early detection of critically ill patients and may trigger early treatment by staff specially trained to handle emergency situations.