Rapid Response Systems

Rapid Response Systems

An elderly man was admitted with an acute abdomen and free air visible under the diaphragm on CXR. He was fluid resuscitated before undergoing emergency laparotomy, where a perforated duodenal ulcer was oversewn. He was admitted to ICU postoperatively, extubated the next morning and deemed fit for discharge to the surgical ward later that day. Due to a lack of surgical beds, he was eventually discharged from ICU at 22:30. Eight hours post discharge, he was urgently re-referred to ICU after being found moribund on the ward. Before he could be seen and assessed he suffered an unrecoverable asystolic arrest. Review of his observation charts showed that there had been a clear deterioration in recorded observations, including hypotension for the two preceeding hours. However, the Early Warning Score had been calculated incorrectly, and no escalation had occurred.

What evidence is there that rapid response systems are effective in preventing patient deterioration and improving outcomes?

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Meet the team

ICM Case Summaries is brought to you by:


Administrators and Lead Editors


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Prad Shanmugasundaram

Consultant ICM and Anaesthesia

Buckinghamshire Healthcare NHS Trust

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Steve Mathieu

Consultant ICM and Anaesthesia

Portsmouth Hospitals NHS Trust

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Jamie Strachan

ICM and Anaesthesia Specialty Registrar

Oxford University Hospitals NHS Trust

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Editor



Dr F RiccioFran Riccio

ICM Clinical Fellow

Portsmouth Hospitals NHS Trust

 

 


Contributors


ICM Case Summaries would like to thank:

Adrian Wong  twitter icon copy

Consultant ICM & Anaesthesia. Oxford University Hospitals NHS Trust

David Garry twitter icon copy

Consultant ICM & Anaesthesia. Oxford University Hospitals NHS Trust

Dave Slessor twitter icon copy

Specialty Registrar in Intensive Care and Emergency Medicine. Health Education Wessex

Sam Clark

Critical Care Echocardiography Fellow. Oxford University Hospitals NHS Trust

Helen Vollmer twitter icon copy

Specialty Registrar in Intensive Care Medicine and Anaesthesia. Royal Berkshire Hospital NHS Foundation Trust

Duncan Chambler twitter icon copy

Specialty Registrar in Intensive Care Medicine and Anaesthesia. Health Education Wessex

Tahir Ali

Specialty Registrar in Intensive Care Medicine and Anaesthesia. Health Education North East (ICM), Health Eduction Thames Valley (Anaesthesia)

Akshay Shah twitter icon copy

Academic Clinical Fellow in Intensive Care Medicine, Specialty Registrar in Anaesthesia. Oxford University Hospitals NHS Trust

Mirae Shin twitter icon copy

Academic Clinical Fellow in Intensive Care Medicine. Oxford University Hospitals NHS Trust

Stuart McKechnie

Consultant ICM and Anaesthesia, Oxford University Hospitals NHS Trust

Craig Walker twitter icon copy

Consultant ICM, St John’s Hospital, Livingston. Consultant EM, Royal Infirmary of Edinburgh

Katherine Francis

Specialty Registrar in Anaesthesia, Oxford University Hospitals NHS Trust

Stephen Shepherd twitter

Specialty Registrar in ICM and Anaesthesia, Barts Healthcare NHS Trust

Ben Harris twitter

Specialty Registrar in Intensive Care Medicine and Anaesthesia. Health Education Wessex

Emma Fitzgerald twitter

Consultant ICM and Anaesthesia. Queen Alexandra Hospital, Portsmouth

David Hepburn twitter

Locum Consultant ICM. Royal Gwent Hospital, Newport