Electronic Appendix
Definitions of serious adverse events

Acute myocardial infarction: presence of all of the following: chest pain ,
EKG changes, and at least on e elevated troponin level

Pulmonary embolism: clinical suspicion of pulmonary embolism and a
high probability ventilation perfusion (V/Q) scan or helical Computerized
tomography (CT) scan

Acute pulmonary edema: clinical suspicion of acute pulmonary edema
and formal radiological confirmation of acute pulmonary edema

Respiratory failure: need for endotracheal intubation and mechanical
ventilation in ICU

Stroke: clinical symptoms and neurological examination suggestive of a
stroke with formal confirmation by CT scan or magnetic resonance (MR)
scan

Severe sepsis: clinical suspicion of infection, hypotension (systolic BP
<90 mmHg and at least one positive blood culture

Acute renal failure: acute need for renal replacement therpay

Emergency ICU admission: unscheduled admission to ICU due to a
clinical complication

Cardiac arrest: sudden onset of lack of palpable pulses , no detectable
blood pressure, unresponsiveness and documentation of initiation of basic
life support
1
Example of early warning score
Score
RR
HR
SBP
O2 sat
3
<8
<40
<85
<85%
2
8-10
40-50
85-90
<90
1
10-12
50-60
90-100
90-93
0
14-25
60-100
100-150
>93%
1
25-30
100-110
150-165
-
2
30-35
110-125
165-180
-
3
>35
>125
>180
-
A warning score of >2 can be used to require increased vigilance, monitoring and
primary team review
A warning score >3 can be used to require urgent primary team review and
continuous monitoring
A warning score of >4 can be used to trigger immediate rapid response team
activation
Different institutions or wards may have different scoring systems and different
triggers for defined responses
2
Summary of ICD-10 code groups
I
II
III
IV
V
VI
VII
VIII
IX
X
XI
XII
XIII
XIV
XV
XVI
XVII
XVIII
XIX
XX
XXI
XXII
A00B99
C00D48
D50D89
E00E90
F00F99
G00G99
H00H59
H60H95
I00-I99
J00J99
K00K93
L00L99
M00M99
N00N99
O00O99
P00P96
Q00Q99
R00R99
S00T98
V01Y98
Z00Z99
U00U99
Certain infectious and parasitic
diseases
Neoplasms
Diseases of the blood and blood-forming organs and certain disorders
involving the immune mechanism
Endocrine, nutritional and metabolic diseases
Mental and behavioural disorders
Diseases of the nervous system
Diseases of the eye and adnexa
Diseases of the ear and mastoid
process
Diseases of the circulatory system
Diseases of the respiratory system
Diseases of the digestive system
Diseases of the skin and subcutaneous tissue
Diseases of the musculoskeletal system and connective
tissue
Diseases of the genitourinary system
Pregnancy, childbirth and the
puerperium
Certain conditions originating in the perinatal
period
Congenital malformations, deformations and chromosomal
abnormalities
Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified
Injury, poisoning and certain other consequences of
external causes
External causes of morbidity and
mortality
Factors influencing health status and contact with health
services
Codes for special purposes
3