The human body has a remarkable ability to compensate for illness. It is this remarkable compensation that hides complications in their early stages. However, it is possible to assess for signs and symptoms of the compensatory mechanisms to detect complications in their early stages.

The above diagram illustrates the concept of identifying complications early on by looking for signs of compensation. When the signs of decompensation occur, the complication has already occurred and we are reacting to the problem, not being proactive.

Look at an example: Mr. Jones is a 58 year-old admitted to your floor for an acute coronary syndrome. While his medication is being adjusted, he develops subjective dyspnea and his respiratory rate increases from 16 to 24. These changes are subtle and easy to ignore or rationalize as being from anxiety. However, they could be compensatory mechanisms to increase oxygenation secondary to the development of early pulmonary edema. Late signs would be hypoxia, rales on auscultation, and evidence on the chest x-ray.

Signs of compensation can be caused by the inflammatory process, ischemia, hypoxia, or decreased cardiac output. To be able to recognize signs of compensation, you must know what to look for.

That is why the "Nurses' Complication Finder" was developed. To help you understand what "Red Flags" to look for and when. The system contains two parts: