From: Reuters
Published November 20, 2007 04:19 PM

Study urges stepped-up response at youth hospitals

CHICAGO (Reuters) - Deploying standby emergency response teams in children's hospitals could have a dramatic impact on death rates, researchers reported on Tuesday.

Some experts have recommended such teams for patients not in intensive care in adult and children's hospitals; but studies have been inconsistent on whether they actually cut death rates in juvenile settings, a team from Lucile Packard Children's Hospital and the Stanford University School of Medicine said.

Their report, published in this week's Journal of the American Medical Association, found that adding a rapid response team to work outside of intensive care units produced an 18 percent drop in the death rate, and about a 70 percent decline in the rate of cardiac and respiratory arrests.

"The potential implications of these findings on national mortality rates for children are dramatic," the report said.


"Future research should focus on replicating these findings in other pediatric inpatient settings, including settings where children are treated in predominantly adult-focused hospitals," it added.

Such teams consist of medical personnel with intensive care unit training who are available around the clock to rush to the aid of patients in the general hospital population whose conditions appear to be deteriorating.

"Even in the hospital, sick children can deteriorate so quickly," said Dr. Paul Sharek, who led the study. "They don't have the energy reserves or muscle mass that most adult patients have."

In the Stanford study the teams were made available beginning in 2005 to proactively respond at the first sign of trouble rather than waiting for further observations or a life-threatening development.

Once a child's heart or breathing stops "the odds of long-term survival are pretty small," Sharek said.

"However, there's often a period of about six to eight hours when a child who might later (have trouble) begins to show subtle signs of distress. If we can intervene early in this process, the child is far more likely to improve than if we simply monitor and maintain the same approach to treatment," he added.

The researchers said some of the cases responded to were triggered simply because the child's caretaker or a parent felt something was not quite right, rather than a change in any vital sign measurement.

"Despite the fact that (response teams) had never been shown to decrease mortality in hospitalized children, we decided to take a chance on this," Sharek said, adding that his team was "excited about the results."

(Reporting by Michael Conlon; Editing by Maggie Fox and David Wiessler)

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