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Pediatric Rapid Response Team

Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
Ashley Siems, Alexander Cartron, Anne Watson, Robert McCarter, Amanda Levin
BACKGROUND: Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. METHODS: In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively...
February 2017: Hospital Pediatrics
Linda Aponte-Patel, Arash Salavitabar, Pamela Fazzio, Andrew Geneslaw, Pamela Good, Anita Sen
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Theodore DeMartini, Adrian Zurca, Kaylee Hollern, Sean Zajdel, Sarah Comly, Lauren Cable, E Scott Halstead
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Shannon N Acker, Beth Wathen, Genie E Roosevelt, Lauren R S Hill, Anna Schubert, Jenny Reese, Denis D Bensard, Ann M Kulungowski
Introduction The rapid response team (RRT) is a multidisciplinary team who evaluates hospitalized patients for concerns of nonemergent clinical deterioration. RRT evaluations are mandatory for children whose Pediatric Early Warning System (PEWS) score (assessment of child's behavior, cardiovascular and respiratory status) is ≥4. We aimed to determine if there were differences in characteristics of RRT calls between children who were admitted primarily to either medical or surgical services. We hypothesized that RRT activations would be called for less severely ill children with lower PEWS score on surgical services compared with children admitted to a medical service...
February 2017: European Journal of Pediatric Surgery
Kimberly Douglas, Jerry Christopher Collado, Sheila Keller
Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations...
October 2016: Critical Care Nursing Quarterly
Phoebe Yager, Corey Collins, Carlene Blais, Kathy O'Connor, Patricia Donovan, Maureen Martinez, Brian Cummings, Christopher Hartnick, Natan Noviski
OBJECTIVE: Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level...
September 2016: International Journal of Pediatric Otorhinolaryngology
Justin Robison, Nicholas B Slamon
OBJECTIVES: Critical care physicians' standard for arrival to a rapid response team activation is 10 minutes or less at this institution. This study proposes that a FaceTime (Apple, Cupertino, CA) video call between the staff at the bedside and the critical care physician will allow the implementation of potentially life-saving therapies earlier than the current average response (4.5 min). DESIGN: Prospective cohort study. SETTING: Freestanding, tertiary-care children's hospital...
September 2016: Pediatric Critical Care Medicine
Hina Walia, Dmitry Tumin, Sharon Wrona, David Martin, Tarun Bhalla, Joseph D Tobias
BACKGROUND: The management of acute pain presents unique challenges in the younger pediatric population. Although patient-controlled devices are frequently used in patients ≥6 years of age, alternative modes of analgesic delivery are needed in infants. OBJECTIVE: To examine the safety and efficacy of nurse-controlled analgesia (NCA) in neonates less than 1 year of age. METHODS: Data from patients <1 year of age receiving NCA as ordered by the Acute Pain Service at our institution were collected over a 5-year period and reviewed retrospectively...
2016: Journal of Pain Research
Fenella J Gill, Gavin D Leslie, Andrea P Marshall
BACKGROUND: Rapid response systems incorporate concepts of early recognition of patient deterioration, prompt reporting, and response which result in escalation of patient care. The ability to initiate escalation of care is now being extended to families of hospitalized patients. RESEARCH AIMS: To identify the impact of implementation of family-initiated escalation of care for the deteriorating patient in hospital? METHODS: A systematic review of peer-reviewed publications was conducted...
August 2016: Worldviews on Evidence-based Nursing
Elizabeth A Biddell, Brian L Vandersall, Stephanie A Bailes, Stephanie A Estephan, Lori A Ferrara, Kristine M Nagy, Joyce L O'Connell, Mary D Patterson
On October 10, 2014, a health care worker exposed to Ebola traveled to Akron, OH, where she became symptomatic. The resulting local public health agencies and health care organization response was unequalled in our region. The day this information was announced, the emergency disaster response was activated at our hospital. The simulation center had 12 hours to prepare simulations to evaluate hospital preparedness should a patient screen positive for Ebola exposure. The team developed hybrid simulation scenarios using standardized patients, mannequin simulators, and task trainers to assess hospital preparedness in the emergency department, transport team, pediatric intensive care unit, and for interdepartmental transfers...
April 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
N'Diris Barry, Karen M Miller, Gregory Ryshen, Joshua Uffman, Thomas A Taghon, Joseph D Tobias
INTRODUCTION: The goal of this study was to identify the etiology of events and demographics of patients that experience complications requiring activation of the Rapid Response Team (RRT) during the first 24 h following anesthetic care. METHODS: We performed a retrospective review of the Quality Improvement database from the Department of Anesthesiology & Pain Medicine at Nationwide Children's Hospital. The database was searched to identify those patients who had a RRT evaluation activated within 24 h of receiving anesthesia or procedural sedation...
May 2016: Paediatric Anaesthesia
Stacey Humphreys, Balagangadhar R Totapally
BACKGROUND: Variability in disposition of children according to the time of rapid response calls is unknown. OBJECTIVE: To evaluate times and disposition of rapid response alerts and outcomes for children transferred from acute care to intensive care. METHODS: Deidentified data on demographics, time and disposition of the child after activation of a rapid response, time of transfer to intensive care, and patient outcomes were reviewed retrospectively...
January 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Mariam A Alansari, Eyad A Althenayan, Mohammed H Hijazi, Khalid A Maghrabi
BACKGROUND: Caregivers in the ambulatory care setting with differing clinical background could encounter a patient at high risk of deterioration. In the absence of a dedicated acute care team, the response to an unanticipated medical emergencies in these settings is likely to have a poor outcome. OBJECTIVE: To describe our experience in implementing an intensivist-led rapid response team (RRT) in the outpatient settings that identified patients who needed immediate Intensive Care Unit (ICU) admission...
October 2015: Saudi Journal of Anaesthesia
Kabir Yadav, James M Chamberlain, Vicki R Lewis, Natalie Abts, Shawn Chawla, Angie Hernandez, Justin Johnson, Genevieve Tuveson, Randall S Burd
BACKGROUND: Use of electronic clinical decision support (eCDS) has been recommended to improve implementation of clinical decision rules. Many eCDS tools, however, are designed and implemented without taking into account the context in which clinical work is performed. Implementation of the pediatric traumatic brain injury (TBI) clinical decision rule at one Level I pediatric emergency department includes an electronic questionnaire triggered when ordering a head computed tomography using computerized physician order entry (CPOE)...
September 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Brian K Owler, Kathryn A Browning Carmo, Wendy Bladwell, T Arieta Fa'asalele, Jane Roxburgh, Tina Kendrick, Andrew Berry
OBJECT: Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients' distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions. METHODS: A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery...
September 2015: Journal of Neurosurgery. Pediatrics
Michael C McCrory, Hanan A Aboumatar, Elizabeth A Hunt
OBJECTIVES: The objective of this study was to explore perceptions of communication quality at pediatric rapid response events and to determine whether these perceptions differed between rapid response team (RRT) members (RRTm) and floor providers (FP). METHODS: This survey study was conducted of clinical providers involved in RRT events at a tertiary care children's hospital. Perceptions of RRT communication were assessed by using a 5-point Likert scale, and qualitative comments were collected...
June 2015: Hospital Pediatrics
Ronen Zipkin, Kathleen Ostrom, Abiola Olowoyeye, Barry Markovitz, Sheree M Schrager
BACKGROUND: The Joint Commission's 2009 National Patient Safety Goals aimed to improve identification of and response to clinical deterioration in hospital-ward patients. Some hospitals implemented intermediate-care units for patients without intensive care-level support needs. No studies have evaluated what effect changes associated with a move to a pediatric cardiovascular step-down unit (CVSDU) has on process-of-care outcomes. METHODS: A retrospective cohort study comparing process-of-care outcomes in units caring for children with congenital heart disease (n=1415) 1 year before (July 1, 2010-June 30, 2011) and 1 year after (August 1, 2011-July 30, 2012) implementation of a CVSDU following the move to a new hospital building...
May 2015: Hospital Pediatrics
Peter M J Lee, Christina Lee, Peter Rattner, Xiaoping Wu, Hayley Gershengorn, Samuel Acquah
OBJECTIVES: Intraosseous access is a rapid and effective route of fluid and drug administration. Its use has been proven in emergency medicine, pediatrics, and the military. We aimed to assess its performance and utilization against landmark-guided central venous catheter placement during inpatient medical emergencies. DESIGN: Prospective observational study. SETTING: Eight hundred fifty-six-bed urban teaching hospital. PATIENTS: Adult inpatients requiring central venous access during medical emergencies...
June 2015: Critical Care Medicine
Nnenna O Chime, Xun Luo, LeAnn McNamara, Akira Nishisaki, Elizabeth A Hunt
OBJECTIVE: Hyperkalemia is one of the reversible causes of cardiac arrest in children. The Advanced Cardiovascular Life Support guidelines have specific recommendations on the choice and sequence of medications for treatment of life-threatening hyperkalemia. However, the Pediatric Advanced Life Support guidelines have no specific treatment recommendations. The objective of this study was to measure the extent to which opinions diverge among pediatricians on the choice and sequence of medication administration in the management of hyperkalemia during cardiac arrest...
June 2015: Pediatric Critical Care Medicine
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