⚠️ Clinical Deterioration [Neurosurgery Wiki]

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====== ⚠️ Clinical Deterioration ======

**Clinical deterioration** refers to a measurable or observable decline in a patient's physiological or neurological status, indicating worsening of the underlying condition or development of new complications.

===== 📌 Key Features =====
  * **Neurological signs**: ↓ Glasgow Coma Scale (GCS), new focal deficits, seizures, agitation, loss of consciousness
  * **Vital sign changes**: hypotension, bradycardia/tachycardia, desaturation, altered respiratory rate
  * **Other red flags**: new onset vomiting, pupillary asymmetry, posturing, confusion

===== 🔁 Context-Specific Examples =====
  * After traumatic brain injury:
    * Drop in GCS ≥2 points
    * Development of anisocoria
  * In postoperative patients:
    * Sudden confusion, restlessness, or motor decline
  * In ICU monitoring:
    * Escalation in oxygen or vasopressor requirements

===== 🧠 Clinical Implications =====
  * May require:
    * Immediate imaging (e.g., urgent CT)
    * Escalation of care (e.g., ICU transfer)
    * Activation of rapid response or code teams
    * Re-evaluation of diagnosis or treatment plan

===== ✅ Best Practice =====
  * Define deterioration criteria clearly in protocols
  * Train staff to recognize early warning signs
  * Ensure structured handovers include baseline status