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Abstract

Introduction: To reduce the incidence of unexpected intentive care unit (ICU) admissions and CPR, rapid response teams (RRTs) have an important role. And, for coming over limitation of resource, our emergency call system for finding and treating critically ill patients earlier in ward was based on electronic medical record-based Dashboard System that detected the abnormality of vital sign, saturation, and made alarms for medical faculty. Methods: RRTs monitored the patients admitted in the non-medical wards from October in 2012 to July in 2013 using electronic medical record-based Dashboard System. Primarily Nurses monitored the patients with unstable vital signs, respiratory difficulty, altered mentality on Dashboard system or other serious concern about overall deterioration notified by medical, paramedical staffs or patients, then discussed it with intensivists. Three hundreds and thirteen patients were accessed by RRTs and one hundred and thirty patients were admitted to ICUs. We analyzed clinical features and outcomes of the patients whom the intensivists made decisions to admit to ICUs and needed CPR calls Results: RRTs accessed 57 patients (44%) with Dashboard system, and 64 patients (49%) with emergency call, a median value of time from activation of RRTs by detecting the patients with above methods to seeing patients by RRTs. Survival rate on discharge from a hospital was 83%(n=108). The patients admitted to surgical center (n=65), orthopedic surgical center (n=16), cardiac and thoracic surgical center (n=8), neurosurgical center (n=1), or other surgical center (n=45) on detection by RRTs. Main causes of detections were low blood pressure (n=33), abnormality of respiratory rate (n=24), desaturation (n=36). Fifty four patients were intubated and needed the mechanical ventilation after admission to ICUs. Median value of modified early warning score was 4. Emergency arousal system that called the CPR team was activated only 2 compared to 8 the period from October in 2011 to July in 2012 in RRTs' monitoring place. CPR team was called in other place that was not monitored by RRTs. Conclusions: We can reduce the incidence of in-hospital CPR and access the deteriorated patients earlier and send them to ICUs by administering the emergency team using Electronic Medical Record-based Dashboard System.