INTEGRATIVE LITERATURE REVIEWS AND META-ANALYSES Critical care outreach services and early warning scoring systems: a review of the literature

Several studies (Franklin & Mathew 1994, Rich 1999), have demonstrated that patients in hospital exhibit premonitory signs of cardiac arrest which may be observed by nursing and medical staff, but are frequently not acted upon. Similar ®ndings have been observed in relation to deterioration in patients' conditions prior to admission to Intensive Care Units (ICU) (Goldhill 1997, McQuillan et al. 1998, Goldhill et al. 1999a, McGloin et al. 1999), with the suggestion that