Epidemiology of early Rapid Response Team activation after Emergency Department admission

Patient physiological status during emergency care and rapid response team or cardiac arrest team activation during early hospital admission

“…Tachypnoea in the ED is well documented as an indicator of poor outcomes and has been associated with increased risk of in-hospital death [33,34], critical care admissions in low-to-moderate acuity ED patients [16], and ICU admissions [20] and RRT activations during the first 24 h of admission [29]. Hypotension is a known predictor of poor outcomes in ED patients, and hypotension during ED care increases the risk of in-hospital death in both trauma [19] and nontrauma patients [18].…”

“…There are few published studies highlighting the emerging phenomenon of RRT or cardiac arrest team (CAT) activation in patients admitted to medical or surgical wards from the ED [8,29,30]. As many as one-quarter of hospital-wide RRT or CAT activations occur among patients admitted to medical or surgical wards through the ED during the first 24 h of emergency admission [8], and up to half of RRT activations occurring in the first 24 h of emergency admission occurred in the first 8 h [30].…”

Patient physiological status at the emergency department–ward interface and emergency calls for clinical deterioration during early hospital admission

“…, Mora et al . ) and 3·3% of patients have an emergency call within 72 hours of hospital admission (Considine et al . ).…”

“…Similarly, respiratory rate at triage and heart rate before ward transfer were predictors of MET activation within 24 hours of transfer from ED to hospital wards (Mora et al . ). For each breath per minute, increase in respiratory rate (OR 1·07, 95% CI 1·02‐1·12) or beat per minute increase in heart rate (OR 1·02, 95% CI 1·002‐1·030) increased the risk of MET activation during the first 24 hours of hospital admission (Mora et al .…”

“…For each breath per minute, increase in respiratory rate (OR 1·07, 95% CI 1·02‐1·12) or beat per minute increase in heart rate (OR 1·02, 95% CI 1·002‐1·030) increased the risk of MET activation during the first 24 hours of hospital admission (Mora et al . ). Again, patients with MET activation within 24 hours of admission, had greater mortality than like patients who did not require a MET call (21% vs. 6%, P = 0·0003).…”