Postoperative Emergency Response Team Activation at a Large Tertiary Medical Center

Weingarten, Toby N.; Venus, Sam; Whalen, Francis X.; Lyne, Brittany J.; Tempel, Holly A.; Wilczewski, Sarah A.; Narr, Bradly J.; Martin, David P.; Schroeder, Darrell R.; Šprung, Juraj

doi:10.1016/j.mayocp.2011.08.003

Cited by 33 publications

(47 citation statements)

References 24 publications

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“…Postoperative hypotension was the predominant reason for rapid response activation, and this was more common in the orthopaedic surgery group when compared to general surgery patients. This finding is similar to an American study, which found that more than 75% of RRS activations in postoperative patients occurred within the first 24 hours on the ward and that the most common reason for RRS activation was haemodynamic instability (Weingarten et al, 2012).…”

Section: Discussionsupporting

confidence: 90%

Frequency, nature and timing of clinical deterioration in the early postoperative period

Iddrisu

Considine

Hutchinson

2018

Journal of Clinical Nursing

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Section: Discussionsupporting

confidence: 90%

Frequency, nature and timing of clinical deterioration in the early postoperative period

Iddrisu

Considine

Hutchinson

2018

Journal of Clinical Nursing

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“…Intraoperative emergency pages should be viewed as the equivalent of “emergency response team” activations. 4 …”

Section: Introductionmentioning

confidence: 99%

Characteristics of Emergency Pages Using a Computer-Based Anesthesiology Paging System in Children and Adults Undergoing Procedures at a Tertiary Care Medical Center

Weingarten

Abenstein²,

Dutton³

et al. 2013

Anesthesia &Amp; Analgesia

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Background In our large academic supervisory practice attending anesthesiologists concomitantly care for multiple patients. To manage communications within the procedural environment, we use a proprietary electronic computer-based anesthesiology visual paging system. This system can send an emergency page which instantly alerts the attending anesthesiologist and other available personnel that immediate help is needed. We analyzed the characteristics of intraoperative emergency pages in children and adults. Methods We identified all emergency page activations between January 1, 2005 and July 31, 2010 in our main operating rooms. Electronic medical records were reviewed for rates and characteristics of pages such as primary etiology, performed interventions, and outcomes. Results During the study period, 258,135 anesthetics were performed (n= 32,103 children, <18 years) and 370 emergency pages (n=309 adults, n=61 children) were recorded (1.4 per 1,000 cases; 95% CI, 1.3–1.6). Infants had the highest rates (9.4 per 1,000; 95% CI, 5.7–14.4) of emergency page activations (P<0.001 compared to each other age group). In adults, the most frequent causes were hemodynamic (55%), and in children respiratory and airway (60.7%). Conclusion Emergency pages were rare in patients older than 2 years. Infants were more likely than children 1–2 yr to have emergency page activation, despite both groups being cared for by pediatric fellowship trained anesthesiologists.

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“…Emergent page sent via the CAPS is somewhat analogous to healthcare team members initiating rapid response team calls for hospitalized patients. 9 …”

Section: Discussionmentioning

confidence: 99%

Emergency Pages Using a Computer-Based Anesthesiology Paging System in Ambulatory Surgical Centers

Warner¹,

Chong

Lowe³

et al. 2014

Anesthesia &Amp; Analgesia

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Background The nature of pages associated with periprocedural emergency events in ambulatory centers has never being examined. Our institution has a proprietary anesthesiology paging system with hierarchal paging capabilities (emergency versus routine) and maintains a log of all events. Here we describe emergency pages in our ambulatory surgery centers. Methods We identified all emergency page activations between June 1, 2008, and December 31, 2012 in our ambulatory surgical centers. Electronic medical records were reviewed for rates and characteristics of pages such as primary cause, interventions performed, and outcomes. Results During the study time frame, 120,618 procedures were performed and 93 emergency pages were recorded (7.7 per 10,000 cases, 95% CI, 6.2 – 9.4), of which 51 originated in the procedure room and 42 outside the procedure room (16 before and 26 after the procedure). Among those 14/93 were associated with serious events (1.2 per 10,000 cases). Among emergency pages for bradyarrhythmias (N=35, 2.9 per 10,000 cases), 15 occurred during intravenous line placement in the preprocedural area, 11 during postprocedural recovery, and 9 during the procedure. Bradyarrhythmias accounted for 60.4% of pages outside the procedural room. In contrast, respiratory and airway events (N=31, 2.6 per 10,000 cases) typically occurred in the procedural room (28 vs. 9, P = 0.0006). Only one patient sustained permanent injury, myocardial infarction and death 4 months later. Another patient died after 8 days from unrelated causes. Conclusion The rates of emergency page activations, especially those representing critical events, in our surgical ambulatory center are rare. Many emergency pages originated outside the procedural room, therefore providers within these areas should be trained to promptly recognize and treat these events.

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Postoperative Emergency Response Team Activation at a Large Tertiary Medical Center

Cited by 33 publications

References 24 publications

Frequency, nature and timing of clinical deterioration in the early postoperative period

Frequency, nature and timing of clinical deterioration in the early postoperative period

Characteristics of Emergency Pages Using a Computer-Based Anesthesiology Paging System in Children and Adults Undergoing Procedures at a Tertiary Care Medical Center

Emergency Pages Using a Computer-Based Anesthesiology Paging System in Ambulatory Surgical Centers

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