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

Anwar-ul-Haque,; Saleem, Ali Faisal; Zaidi, Samreen; Haider, Sajjad

doi:10.1007/s12098-010-0032-2

Cited by 30 publications

(16 citation statements)

References 20 publications

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“…Observational data have been contradictory and have not consistently shown a decreased incidence of cardiac and/or respiratory arrest outside of the ICU setting 14 – 16 . The data addressing effects on hospital mortality were inconclusive 16 – 21 …”

Section: Prearrest Care Updatesmentioning

confidence: 99%

Part 12: Pediatric Advanced Life Support

Caen¹,

Berg²,

Chameides³

et al. 2015

Circulation

425

188

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Section: Prearrest Care Updatesmentioning

confidence: 99%

Part 12: Pediatric Advanced Life Support

Caen¹,

Berg²,

Chameides³

et al. 2015

Circulation

425

188

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“…[19][20][21][22][23][24][25][26][27][28][29]31,[33][34][35][36][37][38][39][40] A cluster-randomized trial and several other observational studies failed to confirm those results. 17,34,36,39,[41][42][43][44][45][46][47][48][49][50][51] The evidence for RRTs or METs and the usefulness of a Pediatric Early Warning System (PEWS) in children is observational but contradictory, and it is not as consistent in showing a decrease in either the incidence of cardiac and/or respiratory arrest outside of the ICU setting [52][53][54] or hospital mortality 53,[55][56][57][58][59] for either PEWS or a MET. However, in a single observational study, PEWS use was associated with a reduction in cardiac arrest rate when used in a single hospital with an established MET system.…”

Section: Early Warning Sign Systems Rapid Response Teams and Medicamentioning

confidence: 99%

Part 4: Systems of Care and Continuous Quality Improvement

Kronick¹,

Kurz²,

Lin³

et al. 2015

Circulation

231

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“…All 7 studies showed that the rate of cardiac arrest outside the ICU declined after institution of a MET/RRT system (unadjusted relative risk [RR] less than 1), but none achieved statistical significance. [14][15][16][17][18][19][20] There was enough potential variability between the studies (of both patient and healthcare system factors, including the baseline incidence of cardiac arrest) that a decision was made to not pool the data.For the critical outcome of all arrests (cardiac and respiratory) outside the ICU, we identified very-low-quality evidence from 4 pediatric observational studies (downgraded for risk of bias and imprecision). One study 21 demonstrated a statistically significant decline (P=0.0008), whereas the other 3 studies 16,22,23 For the important outcome of cardiac arrest frequency, we identified very-low-quality evidence from 1 pediatric observational study 15 (downgraded for risk of bias and imprecision) that was not statistically significant (RR, 0.3; 95% CI, P=0.07).…”

mentioning

confidence: 99%

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

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The Pediatric Task Force reviewed all questions submitted by the International Liaison Committee on Resuscitation (ILCOR) member councils in 2010, reviewed all council training materials and resuscitation guidelines and algorithms, and conferred on recent areas of interest and controversy. We identified a few areas where there were key differences in council-specific guidelines based on historical recommendations, such as the A-B-C (Airway, Breathing, Circulation) versus C-A-B (Circulation, Airway, Breathing) sequence of provision of cardiopulmonary resuscitation (CPR), initial back blows versus abdominal thrusts for foreign-body airway obstruction, an upper limit for recommended chest compression rate, and initial defibrillation dose for shockable rhythms (2 versus 4 J/kg). We produced a working list of prioritized questions and topics, which was adjusted with the advent of new research evidence. This led to a prioritized palate of 21 PICO (population, intervention, comparator, outcome) questions for ILCOR task force focus.The 2015 process was supported by information specialists who performed in-depth systematic searches, liaising with pediatric content experts so that the most appropriate terms and outcomes and the most relevant publications were identified. Relevant adult literature was considered (extrapolated) in those PICO questions that overlapped with other task forces, or when there were insufficient pediatric data. In rare circumstances (in the absence of sufficient human data), appropriate animal studies were incorporated into reviews of the literature. However, these data were considered only when higher levels of evidence were not available and the topic was deemed critical.When formulating the PICO questions, the task force felt it important to evaluate patient outcomes that extend beyond return of spontaneous circulation (ROSC) or discharge from the pediatric intensive care unit (PICU). In recognition that the measures must have meaning, not only to clinicians but also to parents and caregivers, longer-term outcomes at 30 days, 60 days, 180 days, and 1 year with favorable neurologic status were included in the relevant PICO questions.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies 1 and using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) working group.2 After identifying and prioritizing the questions to be addressed (by using the PICO format) 3 with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnosti...

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

Abstract: 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.

Cited by 30 publications

References 20 publications

Part 12: Pediatric Advanced Life Support

Part 12: Pediatric Advanced Life Support

Part 4: Systems of Care and Continuous Quality Improvement

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

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