Title

Experience of Pediatric Rapid Response Team in a Tertiary Care Hospital in Pakistan

Document Type

Article

Department

Paediatrics and Child Health

Abstract

Objective: To report our experience before and after implementation of pediatric rapid response team (RRT) in pediatric wards of a tertiary care hospital in Pakistan. Methods: An audit of RRT activity from December 2007 to August 2008 was conducted and reviewed Patient diagnoses at the time of call placement, interventions done and post-intervention clinical outcomes. Clinical Outcomes in the nine months before RRT implementation were compared with those in the first operational nine months after RRT. Results: Eighty-three calls were generated during the post-intervention study period of 9-month (21 calls/1000 admissions). The median age of Patients was 27 months, 37% calls were for infants. The majority of Patients were under care of medical services (93% vs 7% under care of surgical services). Greater numbers of calls were made during 0800-1600 hours (45%). Respiratory issues were the most common reason for activation of RRT. Because of early interventions, majority (61%) of Patients avoided unnecessary PICU stay and expenditure, only 17% required mechanical ventilation in PICU. The code rate per 1000 admissions decreased from 5.2 (pre-RRT) to 2.7 (post-RRT) (p=0.08, OR 1.88(95% CI 0.9 -3.93). The mortality rate of Patients admitted in PICU from wards decreased from 50% to 15% (p=0.25, OR 1.64 (95% CI 0.63 -4.29). Conclusion: Our experience with implementation of RRT was associated with reduction in cardiorespiratory arrest, mortality and saved a lot of PICU resource utilization. It is an excellent Patient-safety initiative especially in resource-constrained countries by bringing PICU reflexes outside the PICU.

Publication

Indian Journal of Pediatrics