Epidemiology of early Rapid Response Team activation after emergency department admission

Mora, Juan Carlos, Schneider, Antoine, Robbins, Raymond, Bailey, Michael, Bebee, Bronwyn, Hsiao, Yu-Feng Frank, Considine, Julie, Jones, Daryl and Bellomo, Rinaldo 2016, Epidemiology of early Rapid Response Team activation after emergency department admission, Australasian emergency nursing journal, vol. 19, no. 1, pp. 54-61, doi: 10.1016/j.aenj.2015.05.001.

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Title Epidemiology of early Rapid Response Team activation after emergency department admission
Author(s) Mora, Juan Carlos
Schneider, Antoine
Robbins, Raymond
Bailey, Michael
Bebee, Bronwyn
Hsiao, Yu-Feng Frank
Considine, JulieORCID iD for Considine, Julie orcid.org/0000-0003-3801-2456
Jones, Daryl
Bellomo, Rinaldo
Journal name Australasian emergency nursing journal
Volume number 19
Issue number 1
Start page 54
End page 61
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-02
ISSN 1574-6267
Keyword(s) emergency medicine
hospital Rapid Response Team
intensive care units
Summary BACKGROUND: Rapid Response Team (RRT) calls can often occur within 24h of hospital admission to a general ward. We seek to determine whether it is possible to identify these patients before there is a significant clinical deterioration. METHODS: Retrospective case-controlled study comparing patient characteristics, vital signs, and hospital outcomes in patients triggering RRT activation within 24h of ED admission (cases) with matched ED admissions not receiving a RRT call (controls). RESULTS: Over 12 months, there were 154 early RRT calls. Compared with controls, cases had a higher heart rate (HR) at triage (92 vs. 84beats/min; p=0.008); after 3h in the ED (91 vs. 80beats/min; p=0.0007); and at ED discharge (91 vs. 81beats/min; p=0.0005). Respiratory rate (RR) was also higher at triage (21.2 vs. 19.2breaths/min; p=0.001). On multiple variable analysis, RR at triage and HR before ward transfer predicted early RRT activation: OR 1.07 [95% CI 1.02-1.12] for each 1breath/min increase in RR; and 1.02 [95% CI 1.002-1.030] for each beat/minute increase in HR, respectively. Study patients required transfer to the intensive care in approximately 20% of cases and also had a greater mortality: (21% vs. 6%; OR 4.65 [95% CI 1.86-11.65]; p=0.0003) compared with controls. CONCLUSIONS: Patients that trigger RRT calls within 24h of admission have a fourfold increase in risk of in-hospital mortality. Such patients may be identified by greater tachycardia and tachypnoea in the ED.
Language eng
DOI 10.1016/j.aenj.2015.05.001
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, College of Emergency Nursing Australasia
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073906

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