It is not always possible to prevent acute deterioration of patients within a hospital setting. It is always preferable to be proactive in recognising patients at risk rather than reacting after the patient has started to show signs of deterioration.

A patient with a history of epilepsy for example who is admitted to hospital must continue to receive their anti-epileptic medication. It would be inappropriate to withold these medications for too long as this would put them at risk of having a seizure. If the patient is being unable to take their medications orally, it is important to discuss this with the ward pharmacist and identify alternative intravenous preparations that can be prescribed.

All patients admitted to hospital should be asked about alcohol consumption. If the patient is identified as being at risk of alcohol withdrawal they should be prescribed a reducing regimen of chlordiazepoxide.

During hospitalisation the patient's medication chart should be checked regularly. If the kidney or liver function deteriorates during admission there is a risk of drugs accumulating and causing potentially serious side effects. The kidney and liver function should always be checked prior to prescribing medications.

It is important to monitor the GCS in anyone in whom you are suspicious of raised intracranial pressure (e.g. stroke, head injury, CNS infection). If the patient’s GCS is < 9 then their airway is at risk of being compromised by vomit, blood or secretions as normal airway reflexes such as coughing will be diminished.