PURPOSE:To define the most common trigger criteria for Rapid response team (RRT) correlated with the highest ICU admission rate, this information will be helpful in guiding clinical decision for ICU admission and in developing scoring system to predict the need for ICU admission.α.
METHODS:Our hospital is 700 bed tertiary care center,RRT started November 2007, as 24/7 service lead by North American board certified intensivists.Cohort analysis of prospectively collected data of each RRT activation including reason of activation, final disposition of patient and patient,s demographic data.We analyzed each factor separately as independent predictor of ICU admission within 24 hours, in 82 out of 283 patients the team was triggered for more than one reason however each factor was analyzed separately.α.
RESULTS:Total number of activation was 311 patients of which 26 patients were made DNR and remained on floor, 2 patients expired during activation,the remaining 283 patients were analyzed. ICU admission rate was 50.5%,while 49.5% remained on floor. The most common activation criteria leading to ICU admission found to be decrease level of consciousness defined as drop of GCS 2 or more points from baseline (P 0.01) with 66.6% required ICU care,on contrary the most common criteria assosciated with non ICU admission was serious concern with no objective data,(P 0.025)with 72% did not require ICU care,Most common trigger factor of RRT was due to tachypnea 71 patients of which 35 transferred to ICU,serious concern 63 of which 24 patients transferred to ICU,tachycardia 59 of which 31 transferred to ICU,Hypotension 57 of which 32 transferred to ICU,decrease level of consciousness 51 of which 34 transferred to ICU(table 2).α.
CONCLUSION:Our data shows that Decrease level of consciousness has the highest assosciation with the need for ICU admission compared to other factors and may be of higher score in any future scoring system predict the need of ICU admission.α.
CLINICAL IMPLICATIONS:Educating care providers about the importance of early detection of decreased level of consciousness and to have low threshold for admitting them to ICU.α.
DISCLOSURE:Essam Elkady, None.