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Characteristics of Paediatric Patients Requiring Rapid Response System Activations
Taiki Haga1, Takaaki Sakaguchi1, Takuya Matsuda1
1Department of Critical Care Medicine, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima, Osaka-city, Osaka, 534-0021, Japan.
Summary
Paediatric Rapid Response System (RRS) activations are often triggered by respiratory issues. Key indicators for adverse outcomes include low SpO2, low blood pressure, fever, and altered consciousness, guiding RRS protocol optimization.
Area of Science:
- Pediatric Critical Care Medicine
- Healthcare Systems Analysis
- Patient Safety Research
Background:
- Paediatric Rapid Response System (RRS) implementation is growing globally.
- Characteristics and factors influencing adverse outcomes in paediatric RRS are not well understood.
Purpose of the Study:
- To investigate the characteristics of paediatric RRS activations.
- To identify factors associated with adverse outcomes in paediatric patients requiring RRS activation.
Main Methods:
- Retrospective observational study of paediatric patients (<18 years) across 35 Japanese hospitals (Nov 2017 - June 2022).
- Analysis of demographic data, clinical triggers, interventions, and outcomes (ICU transfer, cardiac arrest, death).
- Logistic regression used to identify predictors of adverse outcomes.
Main Results:
- 213 paediatric patients analyzed; median age 47 months.
- Most RRS activations (primarily by nurses) were for respiratory issues; 60% involved interventions.
- Composite adverse outcome rate was 28.6% (4.7% cardiac arrest, 24.9% ICU admission, 1.9% mortality).
- Decreased SpO2, low blood pressure, increased body temperature, altered consciousness, and multiple RRS activation criterion violations/interventions were linked to adverse outcomes.
Conclusions:
- Study provides insights into paediatric RRS activation characteristics and adverse outcome predictors.
- Findings can inform optimization of paediatric RRS protocols.
- Potential to improve paediatric patient safety through enhanced RRS implementation.
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