Rapid Response Team Lowers Hospital Cardiac Arrest Rate

Implementing a rapid response team to aid in managing potentially unstable patients leads to a sharp reduction in the rate of cardiac arrests, claims a new study.

Researchers at the U.S. Veterans Affairs (VA) Medical Center (Palo Alto, CA, USA) evaluated the impact of a rapid response system called the "eTeam” at VA Palo Alto from 2005. During the first two years of implementation, the eTeam was called into action a total of 378 times. The researchers found that the rate of cardiac arrests decreased sharply during this time, from an average of 10.1 cardiac arrests per 1,000 patients at the beginning of the study period to 4.36 at the end, a reduction of 57%. The reduction was even greater, at 64%, in patients undergoing surgery. The hospital death rate also decreased after introduction of the rapid response team by about 17%; however, the researchers clarified that as an overall trend toward reduced mortality was evident, it was impossible to say how much of this reduction was due to the eTeam.

The rapid response system consists of teams of physicians, including intensive care specialists and anesthesiologists, along with nurses and other health care professionals. The members of the team undergo special training in evaluating and treating patients in potentially unstable condition, such as a sudden decrease in breathing or heart rate, a drop in blood pressure, or a change in neurological condition. The researchers believe that even greater benefits would be possible if the eTeam were used to its fullest potential, since the results indicate that medical staff may be reluctant to accept help from the rapid response team in some situations. The study was published in the September 2010 issue of Anesthesia & Analgesia.

"A significant reduction in the rate of cardiac arrests was realized with this intervention, as well as a trend toward lower mortality,” concluded lead author Geoffrey Lighthall, M.D., and colleagues of the department of anesthesiology.” We estimate that 51 arrests were prevented in the timeframe studied. Our results suggest that further reductions in morbidity can be realized by expansion of rapid response systems throughout the Veterans Affairs network.”

"Rapid Response teams are a new approach to quickly intervening when a patient in the hospital is deteriorating,” added Steven Shafer, M.D., of Columbia University (New York, NY, USA), the editor-in-chief of Anesthesia & Analgesia. "The goal is to interrupt the downward spiral that typically precedes cardiopulmonary arrest (code blue).”

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U.S. Veterans Affairs (VA) Medical Center