Use of Physician-Estimated and Patient Self-Reported Weights to Guide Initial Fluid Resuscitation in Emergency Department Patients With Suspected Sepsis
| Autor: | Sunday Clark, Peter A D Steel, Jeremy K. Lessing, William J H Ford, Rahul Sharma, John E. Arbo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Resuscitation medicine.medical_specialty business.industry Elevated Lactate 030208 emergency & critical care medicine Emergency department Critical Care and Intensive Care Medicine medicine.disease Sepsis 03 medical and health sciences 0302 clinical medicine Intravenous fluid Physicians Emergency medicine Fluid Therapy Humans Medicine Self Report 030212 general & internal medicine Emergency Service Hospital business |
| Zdroj: | Journal of Intensive Care Medicine. 36:793-797 |
| ISSN: | 1525-1489 0885-0666 |
| DOI: | 10.1177/0885066620917902 |
| Popis: | Background: Knowledge of patient weight is required to guide initial intravenous fluid therapy for patients with sepsis-associated hypotension or elevated lactate. Previous studies have shown patients are better estimators of their weight than medical providers are; critically ill patients, however, may be unable to provide this information. Objectives: This study compares the accuracy of physician-estimated and patient self-reported weights to subsequent inpatient bed/stretcher scale weights for guiding initial protocol-based intravenous fluid therapy in the treatment of emergency department patients with suspected sepsis. Methods: Adult patients presenting with a suspected diagnosis of severe sepsis to a large, urban, academic emergency department had either physician-estimated or patient self-reported weights recorded on presentation. All patients had subsequent inpatient bed/stretcher scale weights recorded on the first day of hospitalization. Results: Physician-estimated and patient self-reported weights linearly correlated ( P < .001) with inpatient bed/stretcher scale weights. Median accuracy error for physicians (5.4% [2.0-10.1]) and patients (3.9% [1.6-6.4]) was not significantly different ( P = .28). Physician-estimated and patient self-reported weights accuracy was determined at multiple levels: within 5% (46%, 57%, respectively), 10% (75%, 90%), 15% (90%, 95%), and 20% (100%, 95%) error tolerances, as well accurate estimates within 5 kg (69.2%, 70.0%). Conclusions: Both physician-estimated and patient self-reported weights are reliable when calculating initial protocol-based intravenous fluid resuscitation for emergency department patients with sepsis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|