Rapid Response Team Activations in an Israeli Tertiary Care Pediatric Hospital: Analysis of 614 Events

Background: Rapid response teams (RRT) reduce in-hospital mortality and cardiac arrests. There are only a few articles describing RRT activations outside of North America and Australia. Objectives: To describe demographic and clinical variables of RRT activations using 13 years of data. Methods: Schneider Children's Medical Center of Israel is the largest tertiary care pediatric hospital in Israel. We analyzed demographic and clinical data of RRT activation from 1 January 2008 to 31 December 2018. Results: During the study period there were 614 RRT activations with an average of 55.8 activations per year (range 43-76). RRT activations occurred most commonly for children aged 0-12 months (43%) as compared to children 1-5 years of age (25%), 6-10 years of age (12%), 11-18 years of age (18%), and adults (2%). The most common reason for activation was respiratory deterioration (45.8%) followed by neurologic alteration (21%), and cardiac arrest (18%). Following resuscitation, 47% of the patients were admitted to the pediatric intensive care unit and 12% were pronounced dead. Intubation was performed in 48.9% of activations, chest compressions in 20.5%, intraosseous line insertion in 9.4%, and defibrillation in 3.4%. Procedures were more commonly performed in the emergency department (ED). Conclusions: We describe RRT including RRT activations in the ED. The high frequency of interventions should be utilized to direct staff training for the RRT and the ED. The lack of standardization of reporting data for RRT activations makes comparisons among hospitals difficult.