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Editorial |

Pediatric Rapid Response Teams:  Is It Time?

Jeffrey E. Nowak, MD; Richard J. Brilli, MD
JAMA. 2007;298(19):2311-2312. doi:10.1001/jama.298.19.2311.
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In-hospital pediatric cardiopulmonary arrests that occur outside the intensive care unit (ICU) account for between 8.5% and 14% of in-hospital arrests involving children and carry a poor prognosis, with mortality rates of 50% to 67%.14 Reduction or elimination of such arrests should be a high priority for the pediatric health care community.

Rapid response teams (RRTs) were first developed within the adult medical community as a means to decrease in-hospital cardiopulmonary arrests and mortality.5 Rapid response teams usually are part of a hospital system that includes the team, the triggers of the team, the quality process to evaluate the efficacy of the team, and the administrative and financial support for the system. Most studies examining RRTs in adult hospitals have reported decreased arrest rates, lowered mortality rates, or both compared with historical controls,69 although a controlled trial that randomized hospitals to either enact an RRT or continue current practice failed to show benefit.10 This inconsistency has led some to caution against widespread implementation of RRTs, suggesting that the resources required to use an RRT might be better used in other ways.1112 Others suggest that RRTs should be widely implemented because the current data suggest a “relatively large benefit for relatively low risk and cost.”13

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