title: A reduction in cardiac arrests and duration of clinical instability after implementation of a paediatric rapid response system.
abstract: OBJECTIVE
  To determine the effects of a multifaceted paediatric rapid response system on the duration of predefined clinical instability and the subsequent rate of cardiac arrests.
  
  
  METHODS
  An interrupted time series study coupled with a retrospective chart review to evaluate the effects of implementing a four component paediatric rapid response system. All patients in a 136-bed university-affiliated paediatric hospital from August 2003 to May 2007 were considered. The main outcome measures included rate of cardiac arrests as indicated by the number of patient days between ward paediatric cardiac arrests and duration of predefined clinical instability before evaluation by critical care personnel.
  
  
  RESULTS
  The mean time interval between cardiac arrests increased significantly with the establishment of the rapid response system from a baseline of 2512 to 9418 patient days. The median duration of clinical instability decreased from 9 h 55 min to 4 h 15 min post intervention (p=0.028).
  
  
  CONCLUSIONS
  The implementation of a paediatric rapid response system is associated with a significant reduction in the rate of cardiac arrests and duration of clinical instability before evaluation by critical care personnel. This study provides evidence that implementation of a rapid response system brings emergency personnel to deteriorating patients earlier, thus preventing cardiac arrests.
authors.affiliation: Pediatric Critical Care Medicine, University of North Carolina, 214 MacNider Building, Chapel Hill, NC 27599-7221, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Hanson
authors.forename: G D
authors.initials: GD
authors.lastname: Randolph
authors.forename: J A
authors.initials: JA
authors.lastname: Erickson
authors.forename: C M
authors.initials: CM
authors.lastname: Mayer
authors.forename: J T
authors.initials: JT
authors.lastname: Bruckel
authors.forename: B D
authors.initials: BD
authors.lastname: Harris
authors.forename: T S
authors.initials: TS
authors.lastname: Willis
mesh_terms: D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006323:Heart Arrest / Q000517:prevention & control*; D006801:Humans; D007902:Length of Stay; D015588:Observer Variation; D010348:Patient Care Team; D012189:Retrospective Studies; D016896:Treatment Outcome