Interprofessional clinical application of vital signs assessment for early detection of patient deterioration and coordinated decision making-An Updated Review for Healthcare Professionals
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Background: Vital signs represent essential physiological indicators that provide objective insight into patient status and form the foundation of initial clinical assessment. They guide triage decisions, support early recognition of deterioration, and influence outcomes across healthcare settings. Despite their simplicity, vital signs carry strong diagnostic and prognostic value when correctly measured and interpreted. Their variability across populations and clinical environments highlights the need for standardized assessment and interprofessional coordination. Aim: This review aims to examine the interprofessional clinical application of vital signs in early detection of patient deterioration and to evaluate their role in coordinated clinical decision-making across healthcare settings. Methods: A narrative updated review approach was used to synthesize existing literature on vital sign assessment, interpretation, and clinical integration. Evidence from clinical studies, physiological principles, and healthcare practice guidelines was analyzed to explore measurement accuracy, predictive value, and interprofessional roles in monitoring systems such as early warning scores. Results: Findings demonstrate that vital signs remain central to early detection of clinical deterioration, particularly through parameters such as respiratory rate, blood pressure, temperature, and pulse rate. Respiratory rate showed strong predictive value for adverse outcomes, while early warning scores improved risk stratification within 48 hours of assessment. However, significant limitations exist due to measurement variability, especially in respiratory rate and blood pressure. Conclusion: Vital signs remain indispensable in clinical practice, yet their effectiveness depends on accurate measurement, standardized procedures, and interprofessional communication. Early warning systems enhance detection of deterioration, but their reliability relies on proper data collection and interpretation. Strengthening clinical training and team-based approaches improves patient outcomes and reduces preventable adverse events.
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1. Cooper RJ, Schriger DL, Flaherty HL, Lin EJ, Hubbell KA. Effect of vital signs on triage decisions. Ann Emerg Med. 2002 Mar;39(3):223-32.
2. Lockwood C, Conroy-Hiller T, Page T. Vital signs. JBI Libr Syst Rev. 2004;2(6):1-38.
3. Levy N, Sturgess J, Mills P. "Pain as the fifth vital sign" and dependence on the "numerical pain scale" is being abandoned in the US: Why? Br J Anaesth. 2018 Mar;120(3):435-438.
4. Smith GB, Prytherch DR, Jarvis S, Kovacs C, Meredith P, Schmidt PE, Briggs J. A Comparison of the Ability of the Physiologic Components of Medical Emergency Team Criteria and the U.K. National Early Warning Score to Discriminate Patients at Risk of a Range of Adverse Clinical Outcomes. Crit Care Med. 2016 Dec;44(12):2171-2181.
5. Rothschild JM, Gandara E, Woolf S, Williams DH, Bates DW. Single-parameter early warning criteria to predict life-threatening adverse events. J Patient Saf. 2010 Jun;6(2):97-101.
6. Hutchison JS, Ward RE, Lacroix J, Hébert PC, Barnes MA, Bohn DJ, Dirks PB, Doucette S, Fergusson D, Gottesman R, Joffe AR, Kirpalani HM, Meyer PG, Morris KP, Moher D, Singh RN, Skippen PW., Hypothermia Pediatric Head Injury Trial Investigators and the Canadian Critical Care Trials Group. Hypothermia therapy after traumatic brain injury in children. N Engl J Med. 2008 Jun 05;358(23):2447-56.
7. Johansson A. Core Temperature-The Intraoperative Difference Between Esophageal Versus Nasopharyngeal Temperatures and the Impact of Prewarming, Age, and Weight. AANA J. 2019 Feb;87(1):6.
8. Minzola DJ, Keele R. Relationship of Tympanic and Temporal Temperature Modalities to Core Temperature in Pediatric Surgical Patients. AANA J. 2018 Feb;86(1):19-26.
9. Kelly G. Body temperature variability (Part 1): a review of the history of body temperature and its variability due to site selection, biological rhythms, fitness, and aging. Altern Med Rev. 2006 Dec;11(4):278-93.
10. Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ. 2000 Sep 16;321(7262):673-4.
11. Muntner P, Shimbo D, Carey RM, Charleston JB, Gaillard T, Misra S, Myers MG, Ogedegbe G, Schwartz JE, Townsend RR, Urbina EM, Viera AJ, White WB, Wright JT. Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association. Hypertension. 2019 May;73(5):e35-e66.
12. Chester JG, Rudolph JL. Vital signs in older patients: age-related changes. J Am Med Dir Assoc. 2011 Jun;12(5):337-43.
13. Subbe CP, Davies RG, Williams E, Rutherford P, Gemmell L. Effect of introducing the Modified Early Warning score on clinical outcomes, cardio-pulmonary arrests and intensive care utilisation in acute medical admissions. Anaesthesia. 2003 Aug;58(8):797-802.
14. Coupé M, Fortrat JO, Larina I, Gauquelin-Koch G, Gharib C, Custaud MA. Cardiovascular deconditioning: From autonomic nervous system to microvascular dysfunctions. Respir Physiol Neurobiol. 2009 Oct;169 Suppl 1:S10-2.