Application of the mathematical arterialization method may reduce the pain associated with assessment of acid-base and oxygenation status, maximize the information obtained from peripheral venous blood and allow venous measurements to be presented as more commonly interpreted arterial values.

Clinical deterioration in hospitalised patients is often preceded by deterioration in physiological parameters. 1 In 1997, Morgan et al 2 proposed the first early warning score (EWS) system to alert clinicians to deteriorating patients using an aggregated, weighted score of vital signs. Early warning scores generally have a track (abnormal vital signs) and a trigger (predetermined calling or response criteria). 3 The predetermined calling or responses of the EWS often consist of increased observation, alerts to senior

Background Studies have suggested that adding subjective parameters to early warning score (EWS) systems might prompt more proactive treatment and positively affect clinical outcomes. Hence, the study aimed to investigate effect of a situation awareness model consisting of objective and subjective parameters on clinical deterioration in adult emergency department (ED) patients. Methods This controlled pre‐and‐post interventional study was carried out in July–December 2016 and November 2017–April 2018. In ED patients ≥ 18 years, we examined if a situation awareness model compared with a conventional EWS system could reduce clinical deterioration. The new model consisted of a regional EWS, combined with skin observation, clinical concern and patients’ and relatives’ concerns, pain, dyspnea, and team risk assessment. Clinical deterioration was defined as change in vital signs requiring increased observation or physician assessment, that is, increase in early warning score from either 0 or 1 to score ≥2 or an increase from score ≥2 and above. Secondary outcomes were mortality, intensive care unit (ICU) admissions, and readmissions. Results We included 34 556 patients. Patients with two or more registered EWS were included in the primary analysis (N = 21 839). Using difference‐in‐difference regression, we found a reduced odds of clinical deterioration of 21% (OR 0.79 95% CI [0.69; 0.90]) in the intervention groups compared with controls. No impact on mortality, ICU, or readmissions was found. Conclusion The situation awareness model reduces odds of clinical deterioration, defined as a clinically relevant increase in EWS, in an unselected adult population of ED patients. However, there was no effect on secondary outcomes.