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Improved outcomes after implementation of a specialized pediatric cardiac rapid response team

Published online by Cambridge University Press:  24 February 2021

Angela S. McKeta Open the ORCID record for Angela S. McKeta [Opens in a new window] ,
Anthony M. Hlavacek ,
Shahryar M. Chowdhury Open the ORCID record for Shahryar M. Chowdhury [Opens in a new window] ,
Mark Scheurer ,
Eric M. Graham ,
Sinai C. Zyblewski  and
Jason R. Buckley
Angela S. McKeta*
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Anthony M. Hlavacek
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Shahryar M. Chowdhury
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Mark Scheurer
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Eric M. Graham
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Sinai C. Zyblewski
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Jason R. Buckley
Affiliation:
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
*
Author for correspondence: A. S. McKeta, MPAS, PA-C. Department of Pediatrics, Medical University of South Carolina, 10 McClennan Banks Drive, MSC915, Charleston, SC29425, USA. Tel: +1 843 792 5877; Fax: +1 843 792 5878. E-mail: sczypta@musc.edu
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Abstract

Introduction:

The efficacy of a specialized pediatric cardiac rapid response team is unknown. We hypothesized that a specialized cardiac rapid response team would facilitate team-wide communication between the cardiac stepdown unit and cardiac intensive care unit (ICU) teams and improve patient care.

Materials and methods:

A specialized pediatric cardiac rapid response team was implemented in June 2015. All pediatric cardiac rapid response team activations and outcomes from implementation through December 2018 were reviewed. Cardiac arrests and unplanned transfers to the cardiac ICU were indexed to 1000 patient-days to account for inpatient volume trends and evaluated over time.

Results:

There were 202 cardiac rapid response team activations in 108 unique patients during the study period. After implementation of the pediatric cardiac rapid response team, unplanned transfers from the cardiac stepdown unit to the cardiac ICU decreased from 16.8 to 7.1 transfers per 1000 patient days (p = 0.012). The stepdown unit cardiac arrest rate decreased from 1.2 to 0.0 arrests per 1000 patient-days (p = 0.015). There was one death on the cardiac stepdown unit in the 5 years since the implementation of the cardiac rapid response team, compared to four deaths in the previous 5 years.

Conclusions:

A reduction in unplanned cardiac ICU transfers, cardiac arrests, and mortality on the cardiac stepdown unit has been observed since the implementation of a specialized pediatric cardiac rapid response team. A specialized cardiac rapid response team may improve communication and empower the interdisciplinary care team to escalate care for patients experiencing clinical decline.

Keywords

Rapid response teampediatric cardiologycardiac arrest
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 10 , October 2021 , pp. 1582 - 1588
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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