Effects of introducing a rapid response team in a university teaching hospital – preliminary analysis

Dear Editor,

rapid response teams (RRTs) were introduced into hospitals at the beginning of the 90ties of the 20th century, first in Australia and North America and then in Western Europe. The rapid response systems have different names in different countries; nevertheless, their major objective is to identify patients at risk of rapid health deterioration/sudden cardiac arrest (SCA) and to implement appropriate therapy as promptly as possible [1]. In Poland, there is a shortage of hospital beds in intensive care units (ICUs) and medical intensive care units (MICUs), even though the regulation concerning medical standards in anaesthesiology and intensive care states that the number of ICU beds should constitute at least 2% of the total number of beds [2]. According to the findings of meta-analyses available in literature, the incidence of SCA has significantly decreased after the introduction of RRTs [3, 4]. The data regarding RRT interventions and their effectiveness under Polish conditions are sparse. Therefore, the study was designed to analyse RRT interventions performed at the university-affiliated teaching hospital and to assess the effects of RRT introduction.
Seventy-one RRT interventions car­ried out at the university-affiliated teaching hospital between 1.10.2018 and 30.01.2019 were retrospectively analysed. Based on the RRT intervention records, causes of calls, procedures applied during interventions, pharmacotherapy used, and recommendations for further treatment and management were analysed. The total number of intra-hospital transfers to ICU, the number of hospital SCAs as well as mortality rates prior to and following the introduction of RRT were determined. The same period of the previous year was considered a reference point. Moreover, analysis included selected laboratory results of patients on RRT calling, i.e. white blood cell (WBC) count, platelet count, concentrations of C-reactive protein (CRP), glucose, sodium, potassium, chlorides, crea­tinine, total bilirubin, and lactates. The laboratory results were obtained from the medical information technology system. Since the study was retrospective and observational, no consent of the Bioethics Committee was required.
The group of 53 patients treated by RRT consisted of 54% of females and 46% of males; the median age was 64 (IQR 58–76) years. The average number of RRT calls was 0.58/day, 4.06/week, 17.75/month. One-time interventions constituted 75% of all calls....


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