{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:18:36Z","timestamp":1780471116755,"version":"3.54.1"},"reference-count":49,"publisher":"RCNi","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"DOI":"10.7748\/ns.2026.e12626","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T05:50:09Z","timestamp":1777269009000},"page":"67-74","source":"Crossref","is-referenced-by-count":0,"title":["Acute deterioration in adults: pathophysiology of common signs and symptoms"],"prefix":"10.7748","volume":"41","author":[{"given":"Carolyne","family":"Stewart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4499","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"key20260531195549_R1","volume-title":"Critical Care Nursing","year":"2019","edition":"4"},{"key":"key20260531195549_R2","volume-title":"Normal and Abnormal Urine Output and Interpretation","year":"2024"},{"key":"key20260531195549_R3","unstructured":"Alexiou A, Jenkins-Welch M\n (2024) BMJ Best Practice: Accidental Hypothermia. bestpractice.bmj.com\/topics\/en-gb\/654 (Last accessed: 23 March 2026.)"},{"issue":"1","key":"key20260531195549_R4","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/PTS.0000000000000720","article-title":"Failure to rescue deteriorating patients: a systematic review of root causes and improvement strategies","volume":"18","year":"2022","journal-title":"Journal of Patient Safety"},{"issue":"Issue 6","key":"key20260531195549_R5","first-page":"CD010841","article-title":"Peripheral venous blood gas analysis versus arterial blood gas analysis for the diagnosis of respiratory failure and metabolic disturbance in adults","year":"2025","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"6","key":"key20260531195549_R6","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.rmed.2013.02.004","article-title":"Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations","volume":"107","year":"2013","journal-title":"Respiratory Medicine"},{"key":"key20260531195549_R7","first-page":"99","volume-title":"Critical Care Manual of Clinical Nursing Procedures","year":"2025","edition":"2"},{"issue":"11","key":"key20260531195549_R8","doi-asserted-by":"crossref","first-page":"657","DOI":"10.5694\/j.1326-5377.2008.tb01825.x","article-title":"Respiratory rate: the neglected vital sign","volume":"188","year":"2008","journal-title":"Medical Journal of Australia"},{"issue":"1","key":"key20260531195549_R9","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.resuscitation.2006.08.020","article-title":"The objective medical emergency team activation criteria: a case-control study","volume":"73","year":"2007","journal-title":"Resuscitation"},{"issue":"3","key":"key20260531195549_R10","doi-asserted-by":"crossref","first-page":"e277","DOI":"10.1016\/j.jemermed.2023.10.027","article-title":"Body core temperature assessment in emergency care departments","volume":"66","year":"2024","journal-title":"Journal of Emergency Medicine"},{"issue":"5","key":"key20260531195549_R11","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.nurpra.2007.02.021","article-title":"Pulse oximetry: uses and limitations","volume":"3","year":"2007","journal-title":"Journal for Nurse Practitioners"},{"key":"key20260531195549_R12","article-title":"Performance of the afferent limb of rapid response systems in managing deteriorating patients: a systematic review","year":"2019","journal-title":"Critical Care Research and Practice"},{"key":"key20260531195549_R13","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1186\/s13054-015-0950-5","article-title":"Nurses\u2019 worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review","volume":"19","year":"2015","journal-title":"Critical Care"},{"issue":"19-20","key":"key20260531195549_R14","doi-asserted-by":"crossref","first-page":"7560","DOI":"10.1111\/jocn.16843","article-title":"Reflections from the frontline of nursing on acute patient deterioration","volume":"32","year":"2023","journal-title":"Journal of Clinical Nursing"},{"issue":"4","key":"key20260531195549_R15","doi-asserted-by":"crossref","first-page":"ofz032","DOI":"10.1093\/ofid\/ofz032","article-title":"Normal body temperature: a systematic review","volume":"6","year":"2019","journal-title":"Open Forum Infectious Diseases"},{"key":"key20260531195549_R16","volume-title":"Ross and Wilson Pathophysiology","year":"2023"},{"key":"key20260531195549_R17","article-title":"How to interpret arterial blood gas results","year":"2022","journal-title":"Nursing Standard"},{"key":"key20260531195549_R18","article-title":"Suspected sepsis: patient assessment and management in the emergency department","year":"2025","journal-title":"Emergency Nurse"},{"issue":"9","key":"key20260531195549_R19","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1136\/bmjqs-2011-001159","article-title":"Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study","volume":"21","year":"2012","journal-title":"BMJ Quality and Safety"},{"issue":"2","key":"key20260531195549_R20","article-title":"Interventions to reduce mortality from in-hospital cardiac arrest: a mixed-methods study","volume":"7","year":"2019","journal-title":"Health and Social Care Services Delivery Research"},{"issue":"1","key":"key20260531195549_R21","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/nicc.12917","article-title":"Night\u2010time detection and response in relation to deteriorating inpatients: a scoping review","volume":"29","year":"2024","journal-title":"Nursing in Critical Care"},{"issue":"3","key":"key20260531195549_R22","doi-asserted-by":"crossref","first-page":"153","DOI":"10.12968\/bjon.2010.19.3.46535","article-title":"Critical care: assessing blood pressure, circulation and intravascular volume","volume":"19","year":"2010","journal-title":"British Journal of Nursing"},{"issue":"10","key":"key20260531195549_R23","doi-asserted-by":"crossref","first-page":"e0223155","DOI":"10.1371\/journal.pone.0223155","article-title":"Accuracy and interobserver-agreement of respiratory rate measurements by healthcare professionals, and its effect on the outcomes of clinical prediction\/diagnostic rules","volume":"14","year":"2019","journal-title":"PLoS One"},{"issue":"3","key":"key20260531195549_R24","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/MCC.0000000000000194","article-title":"Clinical assessment of peripheral circulation","volume":"21","year":"2015","journal-title":"Current Opinion in Critical Care"},{"key":"key20260531195549_R25","volume-title":"Essentials of Human Anatomy and Physiology","year":"2022","edition":"13"},{"issue":"4","key":"key20260531195549_R26","doi-asserted-by":"crossref","first-page":"102411","DOI":"10.1016\/j.cpcardiol.2024.102411","article-title":"Unraveling the complex pathophysiology of heart failure: insights into the role of renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS)","volume":"49","year":"2024","journal-title":"Current Problems in Cardiology"},{"issue":"1","key":"key20260531195549_R27","first-page":"6","article-title":"What factors influence ward nurses\u2019 recognition of and response to patient deterioration? An integrative review of the literature","volume":"4","year":"2016","journal-title":"Nursing Open"},{"issue":"5","key":"key20260531195549_R28","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/nicc.12582","article-title":"Patient and family involvement in escalating concerns about clinical deterioration in acute adult wards: a qualitative systematic review","volume":"26","year":"2021","journal-title":"Nursing in Critical Care"},{"key":"key20260531195549_R29","article-title":"Respiratory assessment: undertaking a physical examination of the chest in adults","year":"2021","journal-title":"Nursing Standard"},{"key":"key20260531195549_R30","doi-asserted-by":"crossref","first-page":"e022202","DOI":"10.1136\/bmjopen-2018-022202","article-title":"Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review","volume":"8","year":"2018","journal-title":"BMJ Open"},{"key":"key20260531195549_R31","unstructured":"NHS England (2026) Managing Acute Physical Deterioration Through the \u2018Prevention, Identification, Escalation, Response\u2019 (PIER) Approach. www.england.nhs.uk\/patient-safety\/managing-acute-physical-deterioration-through-the-prevention-identification-escalation-response-pier-approach (Last accessed: 23 March 2026.)"},{"issue":"6","key":"key20260531195549_R32","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.bjae.2023.03.002","article-title":"The respiratory system and acid-base disorders","volume":"23","year":"2023","journal-title":"BJA Education"},{"key":"key20260531195549_R33","volume-title":"Pathophysiology: Concepts of Altered Health States","year":"2009","edition":"8"},{"key":"key20260531195549_R34","unstructured":"Resuscitation Council UK (2024) The ABCDE Approach. www.resus.org.uk\/library\/abcde-approach (Last accessed: 23 March 2026.)"},{"issue":"8","key":"key20260531195549_R35","doi-asserted-by":"crossref","first-page":"504","DOI":"10.12968\/bjon.2019.28.8.504","article-title":"The importance of respiratory rate monitoring","volume":"28","year":"2019","journal-title":"British Journal of Nursing"},{"key":"key20260531195549_R36","unstructured":"Royal College of Physicians (2017) National Early Warning Scoring (NEWS) 2: Standardising the Assessment of Acute-Illness Severity in the NHS. www.rcp.ac.uk\/media\/a4ibkkbf\/news2-final-report_0_0.pdf (Last accessed: 23 March 2026.)"},{"key":"key20260531195549_R37","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jcrc.2020.10.016","article-title":"Temperature control in critically ill patients with fever: a meta-analysis of randomized controlled trials","volume":"61","year":"2021","journal-title":"Journal of Critical Care"},{"key":"key20260531195549_R38","unstructured":"Shadman R, Rho RW\n (2026) BMJ Best Practice: Assessment of Tachycardia. bestpractice.bmj.com\/topics\/en-us\/830 (Last accessed: 23 March 2026.)"},{"key":"key20260531195549_R39","doi-asserted-by":"crossref","unstructured":"Sheth Trivedi S\n (2024) Sepsis Guidance Update: What it Means for Nursing Practice. rcni.com\/nursing-standard\/opinion\/expert-advice\/sepsis-guidance-update-what-it-means-for-nursing-practice-204476 (Last accessed: 23 March 2026.)","DOI":"10.7748\/cnp.23.3.10.s4"},{"issue":"8","key":"key20260531195549_R40","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","year":"2016","journal-title":"JAMA"},{"issue":"14","key":"key20260531195549_R41","doi-asserted-by":"crossref","first-page":"51","DOI":"10.7748\/ns.2017.e11030","article-title":"Using the ABCDE approach to assess the deteriorating patient","volume":"32","year":"2017","journal-title":"Nursing Standard"},{"issue":"6","key":"key20260531195549_R42","doi-asserted-by":"crossref","first-page":"2831","DOI":"10.1111\/jan.14830","article-title":"Barriers and enablers of recognition and response to deteriorating patients in the acute hospital setting: a theory\u2010driven interview study using the Theoretical Domains Framework","volume":"77","year":"2021","journal-title":"JAN"},{"issue":"2","key":"key20260531195549_R43","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.mpmed.2024.11.007","article-title":"The management of acute pain \u2013 an update","volume":"53","year":"2025","journal-title":"Medicine"},{"key":"key20260531195549_R44","unstructured":"Soar J, Yeung J, Couper K\n et al (2025) Adult Advanced Life Support Guidelines. www.resus.org.uk\/professional-library\/2025-resuscitation-guidelines\/adult-advanced-life-support-guidelines (Last accessed: 23 March 2026.)"},{"key":"key20260531195549_R45","first-page":"605","volume-title":"Critical Care Nursing","year":"2024"},{"issue":"2","key":"key20260531195549_R46","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.resuscitation.2012.09.021","article-title":"Factors associated with delayed activation of medical emergency team and excess mortality: an Utstein-style analysis","volume":"84","year":"2013","journal-title":"Resuscitation"},{"issue":"12","key":"key20260531195549_R47","doi-asserted-by":"crossref","first-page":"e0144626","DOI":"10.1371\/journal.pone.0144626","article-title":"Non-invasive continuous respiratory monitoring on general hospital wards: a systematic review","volume":"10","year":"2015","journal-title":"PLoS One"},{"key":"key20260531195549_R48","volume-title":"Gould\u2019s Pathophysiology for the Health Professions","year":"2022","edition":"7"},{"key":"key20260531195549_R49","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ijmedinf.2017.01.008","article-title":"An analysis of messages sent between nurses and physicians in deteriorating internal medicine patients to help identify issues in failures to rescue","volume":"100","year":"2017","journal-title":"International Journal of Medical Informatics"}],"container-title":["Nursing Standard"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.rcni.com\/doi\/pdf\/10.7748\/ns.2026.e12626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:40:31Z","timestamp":1780468831000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.rcni.com\/doi\/10.7748\/ns.2026.e12626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,4,27]]},"published-print":{"date-parts":[[2026,6,3]]}},"alternative-id":["10.7748\/ns.2026.e12626"],"URL":"https:\/\/doi.org\/10.7748\/ns.2026.e12626","relation":{},"ISSN":["0029-6570","2047-9018"],"issn-type":[{"value":"0029-6570","type":"print"},{"value":"2047-9018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,27]]}}}