Paediatric Rapid Response Systems: a literature review
Article first published online: 12 MAY 2008
© 2008 The Authors. Journal compilation © 2008 The Acta Anaesthesiologica Scandinavica Foundation
Acta Anaesthesiologica Scandinavica
Volume 52, Issue 7, pages 890–896, August 2008
How to Cite
WINBERG, H., NILSSON, K. and ÅNEMAN, A. (2008), Paediatric Rapid Response Systems: a literature review. Acta Anaesthesiologica Scandinavica, 52: 890–896. doi: 10.1111/j.1399-6576.2008.01672.x
- Issue published online: 9 JUL 2008
- Article first published online: 12 MAY 2008
- Accepted for publication 16 February 2008
- Critical care;
- emergency treatment;
- paediatric hospitals;
- rapid response system;
- medical emergency team;
- rapid response team;
- paediatric early warning score;
- calling criteria
Background: Paediatric cardiorespiratory arrest carries a poor prognosis. The most common cause is respiratory insufficiency or hypotension/shock, which can be reversible. The use of RRSs in adult hospitals that proactively intervene when signs of physiological instability occur is widespread and increasing although the level of evidence for their efficiency is a matter of debate.
Methods: A systematic literature review was undertaken to evaluate and summarise the current knowledge about paediatric RRSs.
Results: Paediatric RRSs are in use in several places around the world. One study shows a statistically significant decrease in mortality rate after implementation. Two studies show a non-significant association with decreased mortality rate. Cardiac and/or respiratory arrest rates decreased in all four before-after studies with statistical significance in two.
Conclusions: Cardiac arrest and death are rare in paediatric hospitals, which can in part explain the difficulties to demonstrate statistically significant benefits. There are also specific problems regarding calling criteria due to age related physiological diversity as well as chronic disease.