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In a retrospective study, investigators evaluated the effect of emergency department (ED) overcrowding on timeliness of reassessment of critical vital signs in patients who presented to a single pediatric ED over 3 years with at least one critical vital sign at triage (outside the 95th percentile for age). When a critical vital sign was noted, an electronic health record–based alert prompted nurses to reassess vital signs within 1 hour. Unstable children requiring immediate triage to the critical resuscitation area were excluded.
Among 9976 patients (mean age, 4 years), mean time to vital sign reassessment was 84 minutes. In an analysis controlled for potential confounders, time to vital sign reassessment was significantly reduced with each …