When you hear these words from an experienced clinician, believe them

Anyone who has worked in medicine for a long time well understands the power of the statement coming from an experienced person: “This kid looks sick.” That person could be a physician or nurse. Years of experience does tend to give one a sort of sixth sense for when to worry something serious is going on that just hasn’t shown itself fully yet. Seasoned parents can often provide the same perspective. A fascinating recent article pertaining to this appeared in Critical Care Medicine, the journal of the Society of Critical Care Medicine, entitled “What faces reveal: a novel method to identify patients at risk of deterioration using facial expressions.” It suggests an empiric perspective for studying just how this phenomenon may work. It’s not about children, but the findings could easily apply to pediatric patients. The authors include experts in empirical evaluation of facial expressions, broken down into something called “action units.” This is a scientific field I have to say I had no idea even existed. They used video recordings of 34 patients identified by nursing as potentially, but not yet, deteriorating clinically. The patients were then followed in time to identify those who ended up in intensive care for deterioration and what their faces were doing just before that. They also used a standard measure in the U.K. for deterioration termed the National Early Warning Score. This is based on objective measures such as heart rate, respiratory rate, level...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Critical Care Hospital-Based Medicine Pediatrics Source Type: blogs