Features and outcome of patients receiving multiple Medical Emergency Team reviews

ICU Admittance by a Rapid Response Team Versus Conventional Admittance, Characteristics, and Outcome*

“…Interestingly, we also found that 60 of the RRT admissions had had another RRT call shortly before their ICU admission. This finding is consistent with those of Calzavacca et al (20) who described that patients with multiple RRTs are a vulnerable group with an increased risk of mortality. ICU stay was also longer for the RRT patients who received noninvasive ventilation to a higher extent.…”

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

“…Our findings support those of other studies that show that 32-34% of patients who require RRT review die in the hospital [24][25][26] and that in-hospital mortality of patients with in-hospital cardiac arrest is 64-77% [37,38]. The relationship between ICU admission from wards and in-hospital death is also well established [39][40][41][42], and ED patients who were admitted to the ICU from the wards had significantly higher mortality than patients who did not require ICU care (37 vs. 3.0%, P <0.001) [39].…”

“…Similarly, physiological derangement in the ED (in particular, altered conscious state, tachypnoea, tachycardia and hypotension) is predictive of hospital admission, admission to critical care departments and in-hospital death [15][16][17][18][19][20]. Implementation of RRTs have been shown to decrease cardiac arrests and ICU admissions in ward patients [21][22][23]; however, the in-hospital mortality of patients who have had an RRT review is as high as 34% [24][25][26]. Given that the overall hospital mortality rates are ∼ 2% [25], RRT activation is now viewed as a high-risk patient event, raising questions of whether even earlier detection and escalation of care for deteriorating patients are needed [27].…”

The rapid response system and end-of-life care

“…In 130 calls (23%), the RRT thought that institution of a do not resuscitate (DNR)/not for resuscitation (NFR) order was appropriate. In 27 cases (3.8%), the RRT actually implemented a new DNR/NFR order during the call.Calzavacca et al[24] studied 1217 RRT calls to 900 patients over 1 year. They found that there was aTable 1.…”