Example cases of deterioration.

A: Patient post-procedure day #1 from stenting of left posterior tibial artery for non-healing ulcer deteriorated into mixed cardiogenic and septic shock. Here charted vital signs were sufficient to identify deterioration in the several hours preceding ICU transfer. B: Patient with heart failure undergoing evaluation for coronary artery bypass grafting quickly deteriorated due to acute renal failure. Progressive derangement of laboratory results identified the deterioration without appreciable change in charted vital signs or continuous ECG monitoring. C: Patient post-operative day #3 from left renal vein transposition who developed abdominal pain with associated tachycardia. CT imaging demonstrated intraabdominal hemorrhage and subsequent hemoglobin level had dropped from 9.6 to 6.0. EMR charted vital signs and lab results failed to appreciate a trend that was apparent for several hours by analytics of ECG monitoring. D: Patient admitted with acute hypoxic respiratory failure and acute kidney injury post-procedure day #0 from chest tube insertion to drain a pleural effusion. While charted vital signs and laboratory results were abnormal, integration of all available data sources accentuates her increasing risk in the several hours prior to ICU transfer.