A children's hospital that added a rapid response medical team for patients not in the intensive care unit saw an 18 percent decrease in the death rate, and about a 70 percent decline in the rate of cardiac and respiratory arrests, according to a study in the November 21 issue of JAMA: The Journal of the American Medical Association.
Introduction of a rapid response team (RRT; medical emergency team) has been shown to decrease death and cardiopulmonary arrests outside of the intensive care unit (ICU) in adult inpatients, according to background information in the article. An RRT is a multidisciplinary team frequently consisting of ICU-trained personnel who are available 24 hours per day, 7 days per week for evaluation of patients not in the ICU who develop signs or symptoms of clinical deterioration.
“The RRT intervention was developed in response to research that revealed adult patients on general medical and surgical hospital units often have evidence of physiological deterioration several hours before cardiopulmonary arrest, and that after a cardiac arrest occurred, survival rates were poor. Given that there appears to be a window of opportunity to identify and proactively treat ‘prearrest' adult inpatients effectively, the Institute for Healthcare Improvement recommended RRTs be implemented nationwide in an effort to decrease inpatient mortality rates,” the authors write. Limited data exist evaluating the effectiveness of RRT implementation in pediatric inpatients.
Paul J. Sharek, M.D., M.P.H., of Stanford University School of Medicine, Palo Alto, Calif., and colleagues evaluated whether RRT implementation was associated with decreases in hospital-wide mortality rates and code rates (respiratory and cardiopulmonary arrests) outside of the ICU in pediatric inpatients at a 264-bed academic children's hospital. Pediatric inpatients who spent at least one day on a medical or surgical ward between January 2001 and March 2007 were included. A total of 22,037 patient admissions were evaluated pre-intervention (before September 1, 2005), and 7,257 patient admissions were evaluated post-intervention (on or after September 1, 2005).