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Title: Epidemiology of early Rapid Response Team activation after Emergency Department admission.
Austin Authors: Mora, Juan Carlos;Schneider, Antoine G;Robbins, Raymond J ;Bailey, Michael;Bebee, Bronwyn ;Hsiao, Yu-Feng Frank;Considine, Julie;Jones, Daryl A ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Department of Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia
Eastern Health - Deakin University Nursing and Midwifery Research Centre/Centre for Quality and Patient Safety Research, Deakin University, Burwood, Australia
Issue Date: Feb-2016 2015-06-09
Publication information: Australasian emergency nursing journal : AENJ 2016; 19(1): 54-61
Abstract: 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. 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). Over 12 months, there were 154 early RRT calls. Compared with controls, cases had a higher heart rate (HR) at triage (92 vs. 84 beats/min; p=0.008); after 3h in the ED (91 vs. 80 beats/min; p=0.0007); and at ED discharge (91 vs. 81 beats/min; p=0.0005). Respiratory rate (RR) was also higher at triage (21.2 vs. 19.2 breaths/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 1 breath/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. 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.
DOI: 10.1016/j.aenj.2015.05.001
ORCID: 0000-0002-1650-8939
PubMed URL: 26071173
Type: Journal Article
Subjects: Emergency medicine
Hospital Rapid Response Team
Intensive Care Units
Appears in Collections:Journal articles

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