⚠️ 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.

• 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

• 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

• 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

• Define deterioration criteria clearly in protocols
• Train staff to recognize early warning signs
• Ensure structured handovers include baseline status