Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
8 "hospital rapid response team"
Filter
Filter
Article category
Keywords
Publication year
Authors
Original Articles
Pediatrics
Eleven years of experience in operating a pediatric rapid response system at a children’s hospital in South Korea
Yong Hyuk Jeon, Bongjin Lee, You Sun Kim, Won Jin Jang, June Dong Park
Acute Crit Care. 2023;38(4):498-506.   Published online November 29, 2023
DOI: https://doi.org/10.4266/acc.2023.01354
  • 1,214 View
  • 54 Download
AbstractAbstract PDFSupplementary Material
Background
Various rapid response systems have been developed to detect clinical deterioration in patients. Few studies have evaluated single-parameter systems in children compared to scoring systems. Therefore, in this study we evaluated a single-parameter system called the acute response system (ARS).
Methods
This retrospective study was performed at a tertiary children’s hospital. Patients under 18 years old admitted from January 2012 to August 2023 were enrolled. ARS parameters such as systolic blood pressure, heart rate, respiratory rate, oxygen saturation, and whether the ARS was activated were collected. We divided patients into two groups according to activation status and then compared the occurrence of critical events (cardiopulmonary resuscitation or unexpected intensive care unit admission). We evaluated the ability of ARS to predict critical events and calculated compliance. We also analyzed the correlation between each parameter that activates ARS and critical events.
Results
The critical events prediction performance of ARS has a specificity of 98.5%, a sensitivity of 24.0%, a negative predictive value of 99.6%, and a positive predictive value of 8.1%. The compliance rate was 15.6%. Statistically significant increases in the risk of critical events were observed for all abnormal criteria except low heart rate. There was no significant difference in the incidence of critical events.
Conclusions
ARS, a single parameter system, had good specificity and negative predictive value for predicting critical events; however, sensitivity and positive predictive value were not good, and medical staff compliance was poor.
Rapid response system
Analysis of avoidable cardiopulmonary resuscitation incidents with a part-time rapid response system in place
Jun Yeun Cho, Dong Seon Lee, Yun Young Choi, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Acute Crit Care. 2021;36(2):109-117.   Published online April 16, 2021
DOI: https://doi.org/10.4266/acc.2020.01095
  • 5,257 View
  • 152 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Although a rapid response system (RRS) can reduce the incidence of cardiopulmonary resuscitation (CPR) in general wards, avoidable CPR cases still occur. This study aimed to investigate the incidence and causes of avoidable CPR.
Methods
We retrospectively reviewed the medical records of all adult patients who received CPR between April 2013 and March 2016 (35 months) at a tertiary teaching hospital where a part-time RRS was introduced in October 2012. Four experts reviewed all of the CPR cases and determined whether each event was avoidable.
Results
A total of 192 CPR cases were identified, and the incidence of CPR was 0.190 per 1,000 patient admissions. Of these, 56 (29.2%) were considered potentially avoidable, with the most common cause being doctor error (n=32, 57.1%), followed by delayed do-not-resuscitate (DNR) placement (n=12, 21.4%) and procedural complications (n=5, 8.9%). The percentage of avoidable CPR was significantly lower in the RRS operating time group than in the RRS non-operating time group (20.7% vs. 35.5%; P=0.026). Among 44 avoidable CPR events (excluding cases related to DNR issues), the rapid response team intervened in only three cases (6.8%), and most of the avoidable CPR cases (65.9%) occurred during the non-operating time.
Conclusions
A significant number of avoidable CPR events occurred with a well-functioning, part-time RRS in place. However, RRS operation does appear to lower the occurrence of avoidable CPR. Thus, it is necessary to extend RRS operation time and modify RRS activation criteria. Moreover, policy and cultural changes are needed prior to implementing a full-time RRS.

Citations

Citations to this article as recorded by  
  • Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
    Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
    Acute and Critical Care.2022; 37(2): 237.     CrossRef
  • A Review of the Commercially Available ECG Detection and Transmission Systems—The Fuzzy Logic Approach in the Prevention of Sudden Cardiac Arrest
    Michał Lewandowski
    Micromachines.2021; 12(12): 1489.     CrossRef
Rapid response system
Effectiveness of a daytime rapid response system in hospitalized surgical ward patients
Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh
Acute Crit Care. 2020;35(2):77-86.   Published online May 13, 2020
DOI: https://doi.org/10.4266/acc.2019.00661
  • 6,522 View
  • 214 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients.
Methods
A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of “do not resuscitate” orders, and the survival of discharged CPA patients.
Results
The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001).
Conclusions
The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.

Citations

Citations to this article as recorded by  
  • Development and Validation of a Machine Learning Algorithm Using Clinical Pages to Predict Imminent Clinical Deterioration
    Bryan D. Steitz, Allison B. McCoy, Thomas J. Reese, Siru Liu, Liza Weavind, Kipp Shipley, Elise Russo, Adam Wright
    Journal of General Internal Medicine.2024; 39(1): 27.     CrossRef
  • Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review
    Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
    Heart & Lung.2024; 63: 51.     CrossRef
  • Clinical significance of acute care surgery system as a part of hospital medical emergency team for hospitalized patients
    Kyoung Won Yoon, Kyoungjin Choi, Keesang Yoo, Eunmi Gil, Chi-Min Park
    Annals of Surgical Treatment and Research.2023; 104(1): 43.     CrossRef
  • The associations between rapid response systems and their components with patient outcomes: A scoping review
    Rebecca J. Piasecki, Cheryl R. Dennison Himmelfarb, Kelly T. Gleason, Rachel M. Justice, Elizabeth A. Hunt
    International Journal of Nursing Studies Advances.2023; 5: 100134.     CrossRef
  • Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
    Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
    Acute and Critical Care.2022; 37(2): 237.     CrossRef
  • Estructura y función de los equipos de respuesta rápida para la atención de adultos en contextos hospitalarios de alta complejidad: Revisión sistemática de alcance
    Juliana Vanessa Rincón-López, Diego Larrotta-Castillo, Kelly Estrada-Orozco, Hernando Gaitán-Duarte
    Revista Colombiana de Obstetricia y Ginecología.2021; 72(2): 171.     CrossRef
  • Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
    Sang Hyuk Kim, Ji Young Hong, Youlim Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards
    Mi-Jung Yoon, Jin-Hee Park
    Journal of Korean Academy of Fundamentals of Nursing.2021; 28(4): 491.     CrossRef
Rapid response system
Utilization of a rapid response team and associated outcomes in patients with malignancy
Jongmin Lee, Woo Ho Ban, Sei Won Kim, Eun Young Kim, Mi Ra Han, Seok Chan Kim
Acute Crit Care. 2020;35(1):16-23.   Published online February 29, 2020
DOI: https://doi.org/10.4266/acc.2019.00675
  • 5,703 View
  • 139 Download
  • 3 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
Recent advances in diagnosis and treatment have improved long-term outcomes in cancer patients. As a result, the requirement for a rapid response team (RRT) for cancer patients is also increasing. This study aimed to analyze utilization of an RRT and the associations between related factors and mortality in a population of cancer patients. Methods: This retrospective cohort study included hospitalized patients at a single academic medical center in Seoul, Korea, who required RRT activation during a 6-year period from June 2013 to December 2018. Results: Overall, 164 of the 457 patients who met the above criteria were cancer patients, and they had a significantly higher Charlson comorbidity score than the non-cancer patients (5.0 vs. 7.0, P<0.001). A significantly larger proportion of cancer patients required intensive care unit transfer (51.8% vs. 41.0%, P=0.032). Cancer patients also had significantly higher in-hospital mortality compared with other patients (39.6% vs. 10.9%, P<0.001). Furthermore, presence of cancer was independently associated with in-hospital mortality (adjusted odds ratio [OR], 2.09; 95% confidence interval [CI], 1.11 to 3.93). Among cancer patients, higher Acute Physiology and Chronic Health Evaluation (APACHE) II at the time of RRT activation was significantly associated with in-hospital mortality regardless of malignancy (adjusted OR, 1.08; 95% CI, 1.01 to 1.15). Conclusions: Cancer patients requiring RRT activation have significantly higher rates of inhospital mortality than patients not using RRT. Higher severity score at the time of RRT activation in patients with malignancy was significantly associated with in-hospital mortality.

Citations

Citations to this article as recorded by  
  • Intensivmedizinisches Kontinuum in der Versorgung von Krebskranken
    Catherina Lück
    InFo Hämatologie + Onkologie.2023; 26(5): 10.     CrossRef
  • Characteristics and outcomes of patients screened by rapid response team who transferred to the intensive care unit
    Song-I. Lee, Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee
    BMC Emergency Medicine.2022;[Epub]     CrossRef
  • Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
    Sang Hyuk Kim, Ji Young Hong, Youlim Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Novel Adaptive T-Cell Oncological Treatments Lead to New Challenges for Medical Emergency Teams: A 2-Year Experience From a Tertiary-Care Hospital in Switzerland
    Anna Sarah Messmer, Yok-Ai Que, Christoph Schankin, Yara Banz, Ulrike Bacher, Urban Novak, Thomas Pabst
    Critical Care Explorations.2021; 3(10): e0552.     CrossRef
  • Outcomes of second-tier rapid response activations in a tertiary referral hospital: A prospective observational study
    Ken Junyang Goh, Hui Zhong Chai, Lit Soo Ng, Joanna Phone Ko, Deshawn Chong Xuan Tan, Hui Li Tan, Constance Wei-Shan Teo, Ghee Chee Phua, Qiao Li Tan
    Annals of the Academy of Medicine, Singapore.2021; 50(11): 838.     CrossRef
  • Effectiveness of Rapid Response Team on In-hospital Mortality in Patients with Hematologic Malignancy
    So-Jung Park, Sang-Bum Hong, Chae-Man Lim, Youn-Suck Koh, Jin-Won Huh
    Quality Improvement in Health Care.2021; 27(2): 18.     CrossRef
Rapid response system
Effect of a rapid response system on code rates and in-hospital mortality in medical wards
Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
Acute Crit Care. 2019;34(4):246-254.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00668
  • 6,286 View
  • 197 Download
  • 8 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
To determine the effects of implementing a rapid response system (RRS) on code rates and in-hospital mortality in medical wards.
Methods
This retrospective study included adult patients admitted to medical wards at Seoul National University Hospital between July 12, 2016 and March 12, 2018; the sample comprised 4,224 patients admitted 10 months before RRS implementation and 4,168 patients admitted 10 months following RRS implementation. Our RRS only worked during the daytime (7 AM to 7 PM) on weekdays. We compared code rates and in-hospital mortality rates between the preintervention and postintervention groups.
Results
There were 62.3 RRS activations per 1,000 admissions. The most common reasons for RRS activation were tachypnea or hypopnea (44%), hypoxia (31%), and tachycardia or bradycardia (21%). Code rates from medical wards during RRS operating times significantly decreased from 3.55 to 0.96 per 1,000 admissions (adjusted odds ratio [aOR], 0.29; 95% confidence interval [CI], 0.10 to 0.87; P=0.028) after RRS implementation. However, code rates from medical wards during RRS nonoperating times did not differ between the preintervention and postintervention groups (2.60 vs. 3.12 per 1,000 admissions; aOR, 1.23; 95% CI, 0.55 to 2.76; P=0.614). In-hospital mortality significantly decreased from 56.3 to 42.7 per 1,000 admissions after RRS implementation (aOR, 0.79; 95% CI, 0.64 to 0.97; P=0.024).
Conclusions
Implementation of an RRS was associated with significant reductions in code rates during RRS operating times and in-hospital mortality in medical wards.

Citations

Citations to this article as recorded by  
  • The role of emergency medical services in the management of in-hospital emergencies: Causes and outcomes of emergency calls – A descriptive retrospective register-based study
    Henna Myrskykari, Timo Iirola, Hilla Nordquist
    Australasian Emergency Care.2024; 27(1): 42.     CrossRef
  • Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review
    Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
    Heart & Lung.2024; 63: 51.     CrossRef
  • Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
    Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
    Critical Care Medicine.2024; 52(2): 314.     CrossRef
  • Rapid Response Systems
    Bradford D. Winters
    Critical Care Clinics.2024; 40(3): 583.     CrossRef
  • Improving sepsis recognition and management
    Merrilee I Cox, Hillary Voss
    Current Problems in Pediatric and Adolescent Health Care.2021; 51(4): 101001.     CrossRef
  • A Somogy Megyei Kaposi Mór Oktató Kórház által bevezetett gyors reagálású rendszer hatása a kórházi mortalitásra
    János Fogas, Rita Koroseczné Pavlin, Krisztina Szabó, Eszter Héra, Imre Repa, Mariann Moizs
    Orvosi Hetilap.2021; 162(20): 782.     CrossRef
  • Evidence revealed the effects of rapid response system
    Jae Hwa Cho
    Acute and Critical Care.2019; 34(4): 282.     CrossRef
Review Article
Rapid response system
Rapid response systems in Korea
Bo Young Lee, Sang-Bum Hong
Acute Crit Care. 2019;34(2):108-116.   Published online May 31, 2019
DOI: https://doi.org/10.4266/acc.2019.00535
  • 12,222 View
  • 399 Download
  • 21 Web of Science
  • 22 Crossref
AbstractAbstract PDF
The inpatient treatment process is becoming more and more complicated with advanced treatments, aging of the patient population, and multiple comorbidities. During the process, patients often experience unexpected deterioration, about half of which might be preventable. Early identification of patient deterioration and the proper response are priorities in most healthcare facilities. A rapid response system (RRS) is a safety net to identify antecedents of these adverse events and to respond in a timely manner. The RRS has become an essential part of the medical system worldwide, supported by all major quality improvement organizations. An RRS consists of a trigger system and response team and needs constant assessment and process improvement. Although the effectiveness and cost-benefit of RRS remain controversial, according to previous studies, it may be beneficial by decreasing in-hospital cardiac arrest and mortality. Since the first implementation of RRS in Korea in 2008, it has been developed in over 15 medical centers and continues to expand. Recent accreditation standards and an RRS pilot program by the Korean government will promote the proliferation of RRSs in Korea.

Citations

Citations to this article as recorded by  
  • Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study
    Yoon Hae Ahn, Jinwoo Lee, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-Man Lim, Sang-Min Lee, Hong Yeul Lee, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Su
    Journal of Intensive Care.2023;[Epub]     CrossRef
  • Findings from a decade of experience following implementation of a Rapid Response System into an Asian hospital
    Augustine Tee, Bryan Peide Choo, Roshni Sadashiv Gokhale, Xiqin Wang, Mashithah Mansor, Hong Choon Oh, Daryl Jones
    Resuscitation Plus.2023; 16: 100461.     CrossRef
  • Development of a comprehensive model for the role of the rapid response team nurse
    Youn-Hui Won, Jiyeon Kang
    Intensive and Critical Care Nursing.2022; 68: 103136.     CrossRef
  • Characteristics and outcomes of patients screened by rapid response team who transferred to the intensive care unit
    Song-I. Lee, Jeong Suk Koh, Yoon Joo Kim, Da Hyun Kang, Jeong Eun Lee
    BMC Emergency Medicine.2022;[Epub]     CrossRef
  • Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study
    Dong-gon Hyun, Su Yeon Lee, Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Jeongwon Heo, Jae-myeong Lee, Kyung Cha
    Critical Care.2022;[Epub]     CrossRef
  • Korean nurses’ perception and performance on communication with physicians in clinical deterioration
    Bo-Gyeong Jin, Kyoungrim Kang, Hyun-Jin Cho
    Medicine.2022; 101(38): e30570.     CrossRef
  • Clinical Nurses’ Intention to Use Defibrillators in South Korea: A Path Analysis
    Dongchoon Uhm, Gye-Hyun Jung
    Healthcare.2022; 11(1): 61.     CrossRef
  • Rapid Response System Should Be Enhanced at Non-general Ward Locations: a Retrospective Multicenter Cohort Study in Korea
    Byung Ju Kang, Sang-Bum Hong, Kyeongman Jeon, Sang-Min Lee, Dong Hyun Lee, Jae Young Moon, Yeon Joo Lee, Jung Soo Kim, Jisoo Park, Jong-Joon Ahn
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Impact of hospitalization duration before medical emergency team activation: A retrospective cohort study
    Jinmi Lee, Yujung Shin, Eunjoo Choi, Sunhui Choi, Jeongsuk Son, Youn Kyung Jung, Sang-Bum Hong, Tai-Heng Chen
    PLOS ONE.2021; 16(2): e0247066.     CrossRef
  • A multicentre validation study of the deep learning-based early warning score for predicting in-hospital cardiac arrest in patients admitted to general wards
    Yeon Joo Lee, Kyung-Jae Cho, Oyeon Kwon, Hyunho Park, Yeha Lee, Joon-Myoung Kwon, Jinsik Park, Jung Soo Kim, Man-Jong Lee, Ah Jin Kim, Ryoung-Eun Ko, Kyeongman Jeon, You Hwan Jo
    Resuscitation.2021; 163: 78.     CrossRef
  • Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
    Sang Hyuk Kim, Ji Young Hong, Youlim Kim
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Predicting severe outcomes using national early warning score (NEWS) in patients identified by a rapid response system: a retrospective cohort study
    Sang Hyuk Kim, Hye Suk Choi, Eun Suk Jin, Hayoung Choi, Hyun Lee, Sang-Hwa Lee, Chang Youl Lee, Myung Goo Lee, Youlim Kim
    Scientific Reports.2021;[Epub]     CrossRef
  • A physician-led medical emergency team increases the rate of medical interventions: A multicenter study in Korea
    Su Yeon Lee, Jee Hwan Ahn, Byung Ju Kang, Kyeongman Jeon, Sang-Min Lee, Dong Hyun Lee, Yeon Joo Lee, Jung Soo Kim, Jisoo Park, Jae Young Moon, Sang-Bum Hong, Amit Bahl
    PLOS ONE.2021; 16(10): e0258221.     CrossRef
  • Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study
    Seung-Hun You, Sun-Young Jung, Hyun Joo Lee, Sulhee Kim, Eunjin Yang
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2021;[Epub]     CrossRef
  • Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards
    Mi-Jung Yoon, Jin-Hee Park
    Journal of Korean Academy of Fundamentals of Nursing.2021; 28(4): 491.     CrossRef
  • Early Warning Score and Cancer Patients at End-of-Life
    Jae-woo Lee, Ye-Seul Kim, Yonghwan Kim, Hyo-Sun Yoo, Hee-Taik Kang
    Korean Journal of Clinical Geriatrics.2021; 22(2): 67.     CrossRef
  • Effectiveness of a daytime rapid response system in hospitalized surgical ward patients
    Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh
    Acute and Critical Care.2020; 35(2): 77.     CrossRef
  • Current State and Strategy for Establishing a Digitally Innovative Hospital: Memorial Review Article for Opening of Yongin Severance Hospital
    Soo-Jeong Kim, Ji Woong Roh, Sungwon Kim, Jin Young Park, Donghoon Choi
    Yonsei Medical Journal.2020; 61(8): 647.     CrossRef
  • Bleeding management after implementation of the Hemorrhage Code (Code H) at the Hospital Israelita Albert Einstein, São Paulo, Brazil
    Michele Jaures, Neila Maria Marques Negrini Pigatti, Roseny dos Reis Rodrigues, Fernanda Paulino Fernandes, João Carlos de Campos Guerra
    Einstein (São Paulo).2020;[Epub]     CrossRef
  • Management of post-cardiac arrest syndrome
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 173.     CrossRef
  • Effect of a rapid response system on code rates and in-hospital mortality in medical wards
    Hong Yeul Lee, Jinwoo Lee, Sang-Min Lee, Sulhee Kim, Eunjin Yang, Hyun Joo Lee, Hannah Lee, Ho Geol Ryu, Seung-Young Oh, Eun Jin Ha, Sang-Bae Ko, Jaeyoung Cho
    Acute and Critical Care.2019; 34(4): 246.     CrossRef
  • Evidence revealed the effects of rapid response system
    Jae Hwa Cho
    Acute and Critical Care.2019; 34(4): 282.     CrossRef
Original Articles
Cardiology/Pediatric
Effectiveness of Bradycardia as a Single Parameter in the Pediatric Acute Response System
Yu Hyeon Choi, Hyeon Seung Lee, Bong Jin Lee, Dong In Suh, June Dong Park
Korean J Crit Care Med. 2014;29(4):297-303.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.297
  • 4,441 View
  • 51 Download
  • 3 Crossref
AbstractAbstract PDF
BACKGROUND
Various tools for the acute response system (ARS) predict and prevent acute deterioration in pediatric patients. However, detailed criteria have not been clarified. Thus we evaluated the effectiveness of bradycardia as a single parameter in pediatric ARS.
METHODS
This retrospective study included patients who had visited a tertiary care children's hospital from January 2012 to June 2013, in whom ARS was activated because of bradycardia. Patient's medical records were reviewed for clinical characteristics, cardiologic evaluations, and reversible causes that affect heart rate.
RESULTS
Of 271 cases, 261 (96%) had ARS activation by bradycardia alone with favorable outcomes. Evaluations and interventions were performed in 165 (64.5%) and 13 cases (6.6%) respectively. All patients in whom ARS was activated owing to bradycardia and another criteria underwent evaluation, unlike those with bradycardia alone (100.0% vs. 63.2%, p = 0.016). Electrocardiograms were evaluated in 233 (86%) cases: arrhythmias were due to borderline QT prolongation and atrioventricular block (1st and 2nd-degree) in 25 cases (9.2%). Bradycardia-related causes were reversible in 202 patients (74.5%). Specific causes were different in departments at admission. Patients admitted to the hemato-oncology department required ARS activation during the night (69.3%, p = 0.03), those to the endocrinology department required ARS activation because of medication (72.4%, p < 0.001), and those to the gastroenterology department had low body mass indexes (32%, p = 0.01).
CONCLUSIONS
Using bradycardia alone in pediatric ARS is not useful, because of its low specificity and poor predictive ability for deterioration. However, bradycardia can be applied to ARS concurrently with other parameters.

Citations

Citations to this article as recorded by  
  • Effect of Diurnal Variation of Heart Rate and Respiratory Rate on Activation of Rapid Response System and Clinical Outcome in Hospitalized Children
    Lia Kim, Kyoung Sung Yun, June Dong Park, Bongjin Lee
    Children.2023; 10(1): 167.     CrossRef
  • Eleven years of experience in operating a pediatric rapid response system at a children’s hospital in South Korea
    Yong Hyuk Jeon, Bongjin Lee, You Sun Kim, Won Jin Jang, June Dong Park
    Acute and Critical Care.2023; 38(4): 498.     CrossRef
  • Pediatric triage modifications based on vital signs: a nationwide study
    Bongjin Lee, June Dong Park, Young Ho Kwak, Do Kyun Kim
    Clinical and Experimental Emergency Medicine.2022; 9(3): 224.     CrossRef
Usefulness of Screening Criteria System Used by Medical Alert Team in a General Hospital
Hyejin Joo, So Hee Park, Sang Bum Hong, Chae Man Lim, Younsuck Koh, Young Seok Lee, Jin Won Huh
Korean J Crit Care Med. 2012;27(3):151-156.
DOI: https://doi.org/10.4266/kjccm.2012.27.3.151
  • 3,188 View
  • 61 Download
  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
Rapid response team (RRT) is becoming an essential part of patient safety by the early recognition and management of patients on general hospital wards. In this study, we analyzed the usefulness of screening criteria of RRT used at Asan Medical Center.
METHODS
On a retrospective basis, we reviewed the records of 675 cases in 543 patients that were managed by RRT (called medical alert team in the Asan Medical Center), from July 2011 to December 2011. The medical alert team was acted by requests of attending doctors or nurses or the medical alert system (MAS) criteria composed of abnormal vital sign, neurology, laboratory data and increasing oxygen demand. We investigated the patterns of MAS criteria for targeting the patients who were managed by the medical alert team.
RESULTS
Respiratory distress (RR > 25/min) was the most common item for identifying patients whose condition had worsened. The criteria consist with respiratory distress and abnormal blood pressure (mean BP < 60 mmHg or systolic BP < 90 mmHg) found 70.0% of patients with deteriorated conditions. Vital sign (RR > 25/min, mean BP < 60 mmHg or systolic BP < 90 mmHg, pulse rate, PR > 130/min or < 50/min) and oxygen demand found 79.2% of them. Vital signs, arterial blood gas analysis (ABGA) with lactate level (pH, pO2, pCO2, and lactate) and O2 demand found 98.6% of patient conditions had worsened.
CONCLUSIONS
Vital signs, especially RR > 25/min is useful criteria for detecting patients whose conditions have deteriorated. The addition of ABGA data with lactate levels leads to a more powerful screening tool.

Citations

Citations to this article as recorded by  
  • Influence of the Rapid Response Team Activation via Screening by Nurses on Unplanned Intensive Care Unit Admissions
    Ye-Ji Huh, Seongmi Moon, Eun Kyeung Song, Minyoung Kim
    Korean Journal of Adult Nursing.2020; 32(5): 539.     CrossRef
  • Early Experience of Medical Alert System in a Rural Training Hospital: a Pilot Study
    Maru Kim
    The Korean Journal of Critical Care Medicine.2017; 32(1): 47.     CrossRef
  • Temporal patterns of change in vital signs and Cardiac Arrest Risk Triage scores over the 48 hours preceding fatal in‐hospital cardiac arrest
    HyunSoo Oh, KangIm Lee, WhaSook Seo
    Journal of Advanced Nursing.2016; 72(5): 1122.     CrossRef
  • A combination of early warning score and lactate to predict intensive care unit transfer of inpatients with severe sepsis/septic shock
    Jung-Wan Yoo, Ju Ry Lee, Youn Kyung Jung, Sun Hui Choi, Jeong Suk Son, Byung Ju Kang, Tai Sun Park, Jin-Won Huh, Chae-Man Lim, Younsuck Koh, Sang Bum Hong
    The Korean Journal of Internal Medicine.2015; 30(4): 471.     CrossRef

ACC : Acute and Critical Care