Experience of pediatric rapid response team in a tertiary care hospital in Pakistan

Indian J Pediatr. 2010 Mar;77(3):273-6. doi: 10.1007/s12098-010-0032-2. Epub 2010 Feb 22.


Objective: To report our experience before and after implementation of pediatric rapid response team (RRT) in pediatric wards of a tertiary care hospital in Pakistan.

Methods: An audit of RRT activity from December 2007 to August 2008 was conducted and reviewed patient diagnoses at the time of call placement, interventions done and post-intervention clinical outcomes. Clinical Outcomes in the nine months before RRT implementation were compared with those in the first operational nine months after RRT.

Results: Eighty-three calls were generated during the post-intervention study period of 9-month (21 calls/1000 admissions). The median age of patients was 27 months; 37% calls were for infants. The majority of patients were under care of medical services (93% vs 7% under care of surgical services). Greater numbers of calls were made during 0800-1600 hours (45%). Respiratory issues were the most common reason for activation of RRT. Because of early interventions, majority (61%) of patients avoided unnecessary PICU stay and expenditure; only 17% required mechanical ventilation in PICU. The code rate per 1000 admissions decreased from 5.2 (pre-RRT) to 2.7 (post-RRT) (p=0.08; OR 1.88 (95%Cl 0.9-3.93). The mortality rate of patients admitted in PICU from wards decreased from 50% to 15% (p=0.25; OR 1.64 (95%Cl 0.63-4.29).

Conclusion: Our experience with implementation of RRT was associated with reduction in cardiorespiratory arrest, mortality and saved a lot of PICU resource utilization. It is an excellent patient-safety initiative especially in resource-constrained countries by bringing PICU reflexes outside the PICU.

MeSH terms

  • Child, Preschool
  • Clinical Audit
  • Hospital Mortality
  • Hospital Rapid Response Team / statistics & numerical data*
  • Humans
  • Infant
  • Intensive Care Units, Pediatric / statistics & numerical data
  • Intubation, Intratracheal / statistics & numerical data
  • Outcome Assessment, Health Care*
  • Pakistan
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies