Rapid response team led by pediatricians: Experience at a Latin American Tertiary Care Hospital

Abstract

Pediatric rapid response teams (PRRT) aim to detect the clinical deterioration of a patient and implement timely treatment, avoiding cardiopulmonary arrests (CPA) and in-hospital mortality.

Objective: To describe the experience with PRRT led by the pediatrician in a high-complexity hospital.

Patients and Methods: Descriptive, retrospective, longitudinal study. Hospitalized children under 18 years of age who had a PRRT activation between August 2015 and May 2022 were included. Patients who simultaneously had an activation of the emergency system (suspected CPA) were excluded. Demographic and clinical variables were analyzed through a descriptive analysis.

Results: We analyzed 225 PRRT events with an activation rate of 17 per 1,000 admissions. Activations were more common in children under two years of age (50%), oncology patients (35%), general hospitalization (88%), the night shift (44%), and respiratory compromise (48%). Most evaluations occurred within the first five minutes (74%). The most frequent interventions were oxygen administration (45%), fluid bolus (43%), laboratory tests (40%), and X-rays (34%). Admission to the pediatric intensive care unit was 45%. The decrease in inpatient CRP was progressive during the time of the study.

Conclusions: With the implementation of the PRRT, we found a tendency toward fewer CPA events in hospital wards. Most of the therapeutic interventions derived from the PRRT were of low or medium complexity, which supports the pediatrician as the team leader.