Rapid Response System (RRS) - jsem.me

1 Rapid Response System (RRS).. RRS .. RRS . Early Warning Scoring System (EWSS) . RRS 4 .. 1. How to cite this material: 5 Million Lives Campaign. Getting Started Kit: Rapid Response Teams. Cambridge, MA: Institute for Healthcare Improvement; 2008. (Available at ). 2. Rapid Response System . 2005 6 the International Conference on Medical Emergency Team ( International Conference on Medical Emergency Team: ICMT ) . MET . 4 Rapid Response System .. Devita MA, Bellomo R, Hillman K, et al. Findings of the first consensus conference on medical emergency teams. Crit Care Med. 2006 Sep;34(9):2463-2478. RRS . 2005 6 ICMET . Medical Emergency Team (MET) : .. Rapid Response Team (RRT) : . MET .. Critical Care Outreach (CCO) Team : ICU.

2 ICU .. 3.. MET, RRT .. Rapid Response System (RRS) . RRS .. Early Warning Scoring System (EWSS) .. EWSS 2 . EWSS .. 4.. 70 45/64 8 .. Schein RM, Hazday N, Pena M, et al. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990;98:1388-1392. 66 (99/150) 6 . 25 (25/99) . Franklin C, Mathew J. Developing strategies to prevent in hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994;22(2):244-247. 6 .. 51 17 . Buist M, Bernard S, Nguyen TV, Moore G, Anderson J. Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation. 2004;62(2):137-141. Franklin 6 . <70,>130mmHg <45,>125 per minute <10,>30 per minute.

3 Franklin C, Mathew J. Developing strategies to prevent in hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994;22(2):244-247. 5. RRS . ICU 50 . Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ. 2002;324:387-390. ICU 58 37 . Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916-921. ICU (4% vs. 30%). Goldhill DR, Worthington L, Mulcahy A, Tarling M, Sumner A. The patient-at-risk team: identifying and managing seriously ill ward patients.

4 Anesthesia. 1999;54(9):853-860. 100 . /1000 - ( 1,000 . ). Sharek PJ, Layla M, Parast LM, et al. Effect of a Rapid Response team on hospital-wide mortality and code rates outside the ICU in a children's hospital. JAMA. 2007;298(19):2267-2274. 17 1,000 . DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL. Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf health care. 2004;13(4):251-254. 6. Early Warning Scoring System (EWSS) . (EWSS) ICU . EWSS . Goldhill DR, McNarry AF, Mandersloot G and McGinley A. A physiologically-based early warning score for ward patients: the association between score and outcome. Anaesthesia. 2005 Jun;60(6):547-55. Barking, Havering & Redbridge University Hospitals NHS Trust.

5 101 200. 9 20. 51 110. 90 . 1mL/kg/2 .. RRT . 2 30 . 7. RRS 4 . Afferent limb . Efferent limb . Evaluate or Process Improvement limb ( ) .. Administrative limb . Afferent limb .. RRS . EWSS . Efferent limb . RRS . MET,RRT ICU .. MET,RRT 3 closed loop communication . Evaluate or Process Improvement limb ( ) . RRS RRS .. Administrative limb . RRS RRS .. RRS .. 8. RRS .. MET, RRT . MET, RRT . MET, RRT .. RRS . RRS .. MET, RRT . ICU . ICU . ICU . ICU . ICU .. 4 .. MET, RRT . MET, RRT MET, RRT . 9. ICU . MET, RRT . MET, RRT . RRS .. 8 36 .. 5 SpO2 85 .. 40 130 160 . 90 200 .. 50ml/4hr .. 10 .. HCU .. 30 . MET, RRT .. 10. MET, RRT .. PHS.. MET, RRT . ACLS MET, RRT .. SBAR .. MET, RRT .. SBAR . MET, RRT .. RRS 3 . 1,000.

6 ICU . RRT . 11. RRT .. 12.. IHI .. 3 .. Plan-Do-Study-Act (PDSA) cycle .. PDSA .. 13. RRS .. Tips: . MET, RRT .. MET,RRT .. MET,RRT .. MET,RRT .. MET,RRT .. MET,RRT .. ACLS . 14. Tips: MET,RRT .. Failure-to-rescue .. MET,RRT . MET,RRT .. MET,RRT .. 15.