Managing the Prevention of In-Hospital Resuscitation by Early Detection and Treatment of High-Risk Patients

Abstract

In hospitalized patients, cardiorespiratory collapse mostly occurs after a distinct period of deterioration. This deterioration can be discovered by a systematic quantification of a set of clinical parameters. The combination of such a detection system-to identify patients at risk in an early stage-and a rapid response team-which can intervene immediately-can be implemented to prevent life-threatening situations and reduce the incidence of in-hospital cardiac arrests outside the intensive care setting. The effectiveness of both of these systems is influenced by the used trigger criteria, the number of rapid response team (RRT) activations, the in-or exclusion of patients with a DNR code >3, proactive rounding, the team composition, and its response time. Each of those elements should be optimized for maximal efficacy, and both systems need to work in tandem with little delay between patient deterioration, accurate detection, and swift intervention. Dependable diagnostics and scoring protocols must be implemented, as well as the organization of a 24/7 vigilant and functional experienced RRT. This implies a significant financial investment to provide an only sporadically required fast intervention and sustained alertness of the people involved.