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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 | Date: | 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. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/18753 | DOI: | 10.1016/j.aenj.2015.05.001 | ORCID: | 0000-0002-1650-8939 | Journal: | Australasian emergency nursing journal : AENJ | PubMed URL: | 26071173 | Type: | Journal Article | Subjects: | Emergency medicine Hospital Rapid Response Team Intensive Care Units Mortality Triage |
Appears in Collections: | Journal articles |
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