Embed Size (px)
Citation preview
IMED RESEARCH GRO
UP
Rapid Response Team Keeping Emergencies in Mind
Claudia G L Jorge, MD; Camila P Vasconcelos, MD; Leonardo Brauer, MD; Carlos A Dias, MD.
Intensimed Research Group – Hospital São Camilo, São Paulo, Brazil
Problem Statement:
The Rapid Response Team (RRT) is a team of clinicians who bring criOcal care experOse to the bedside. Early idenOficaOon of unexpected clinical deterioraOon and acOvaOon of the RRT is paramount for early intervenOons.
In our hospital, we observed a low number of acOvaOons of the Rapid Response Team and a high number of cardiac arrest in the wards.
Aim:
To increase the number of RRT acOvaOons by training the ward's medical and nursing staff.
Ac:ons Taken:
All the nursing and medical staff were trained.
The training consisted in lectures given to all our staff on the importance of recognizing signs of acute clinical deterioraOon and how to do it correctly. The RRT acOvaOon criteria is 2 of the following:
1. Systolic Blood Pressure <90mmHg or >180mmHg;
2. Heart Rate <50 or >100 bpm;
3. Respiratory Rate <8 or >20 bpm;
4. Temperature <36 or >38oC;
5. Pain (new or agravaOon of previous one);
6. Alterated level of consciousness;
7. Capillary filling >2sec;
8. SaturaOon O2 <90%;
9. Absent diureses in the previous 6 hours;
10. Impression of clinical deterioraOon.
The lectures were followed by a month-‐long campaign that consisted in awareness propaganda and a "compeOOon" between floors for the highest correct acOvaOon of the RRT.
Results:
The mean acOvaOon of the RRT in the 18 months previous to our intervenOon was 18,2/month with 1,5 acOvaOons/month due to cardiac arrest. In the 6 months that followed the training our mean acOvaOon rose to 41,6/month with an important drop in acOvaOons due to cardiac arrest – 0,3 acOvaOons/month.
Message for Readers:
This intervenOon shows the importance of training the hospital staff in recognizing acute criOcal deterioraOon signs and symptoms. We observed an important reducOon in cardiac arrests outside of criOcal areas and to us, this is a very important end-‐point.
0
10
20
30
40
50
60
1 2 3 4 5 6
Comparison of the RRT ac:va:ons before and aAer interven:on
nov 2011 -‐ april 2012
nov 2012-‐ april 2013
Nov Dez Jan Fev Mar Apr
Contact: Camila Paiva de Vasconcelos – [email protected]
1
2 2
1 1
2
0
1
0 0 0
1
0
0,5
1
1,5
2
2,5
1 2 3 4 5 6
RRT ac:va:ons due to cardiac arrest before and aAer interven:on
Nov 2011-‐ Apr 2012
Nov 2012-‐ Apr 2013
Nov Dez Jan Fev Mar Apr
