Retrospective review of emergency response activations during a 13-year period at a tertiary care children's hospital

J Hosp Med. 2011 Mar;6(3):131-5. doi: 10.1002/jhm.832. Epub 2010 Nov 24.

Abstract

Objectives: Pediatric in-hospital arrests are uncommon but are associated with poor outcomes. In preparation for implenting a Rapid Response Team (RRT) at The Children's Hospital, we reviewed our data collection of 13 years of emergency response team (ERT) activations. We describe demographic and clinical variables, including outcomes of ERT activations at a free-standing tertiary care children's hospital.

Methods: Analysis was performed on data collected from January 1993 through July 2007. Variables collected included age, sex, admission diagnosis, core event, admission diagnosis and secondary diagnosis, medical division or winter/nonwinter months, day/night shifts, survival of core event, survival to discharge, and primary attending service.

Results: There were 1537 ERT activations in the database, 203 were eliminated due to missing data or were adult visitors/employees. The remaining 1334 were included for analysis. Our results showed 39%(511) of all ERT activations occurred in patients under 1 year of age. The most common admission diagnosis category was cardiac disease. There was no statistical significance between summer and winter months although more activations occurred during daytime hours (P < .001). Survival rate of an ERT was 90%, with a 78% survival rate to discharge.

Conclusion: Our data support the general belief that younger children with chronic disease are at highest risk for ERT activations. These risk factors should be taken into consideration when planning patient placement, medical staffing, and the threshold for ICU consultations or admissions. More extensive multisite studies using clinical data are necessary to further identify hospitalized children at risk for sudden decompensation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / standards
  • Emergency Service, Hospital / trends*
  • Female
  • Follow-Up Studies
  • Hospital Rapid Response Team / standards
  • Hospital Rapid Response Team / trends*
  • Hospitals, Pediatric / standards
  • Hospitals, Pediatric / trends*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Risk Factors