Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2012 Dec;83(12):1434-7.
doi: 10.1016/j.resuscitation.2012.07.017. Epub 2012 Jul 24.

Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses

David S Morris  1 , William Schweickert, Daniel Holena, Robert Handzel, Carrie Sims, Jose L Pascual, Babak Sarani
Affiliations
Comparative Study

Differences in outcomes between ICU attending and senior resident physician led medical emergency team responses

David S Morris et al. Resuscitation. 2012 Dec.

Abstract

Introduction: Although rapid response systems (RRS) have been shown to decrease the incidence of cardiac arrest (CA), there are no studies evaluating optimal staffing. We hypothesize that there are no outcome differences between ICU physician and senior resident led events.

Methods: A retrospective study of the RRS database at a single, academic hospital was performed from July 1, 2006 to May 31, 2010. Surgical patients and those in the ICU were excluded. Daytime (D) was defined as 7 am-5 pm Monday through Friday, and weekends were defined as 5 pm on Friday to 6:59 am on Monday. The nurse to patient ratio is constant during all shifts. An ICU physician leads daytime events on weekdays whereas night/weekend (NW) events are led by residents. NW events were compared against D events using chi square or Fischer's exact test. Significance was defined as p<0.05.

Results: A total of 1404 events were reviewed with 534 (38%) D and 870 (62%) NW events. Respiratory and staff concerns were more likely during NW compared to D (50% vs. 39% and 46% vs. 34%, p<0.001, respectively). Following RRS activation, no difference was noted between D and NW periods in the incidence of progression to CA, transfer to ICU, or hospital mortality. Invasive procedures were more common in the NW period.

Conclusion: Resident-led RRS may have similar outcomes to attending intensivist led events. Prospective studies are needed to determine the ideal team composition.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement

The authors do not have any financial, personal, or other conflicts of interest with any materials related to this work.

Figures

Fig. 1
Fig. 1
Percentage of rapid response calls in each cohort.
See this image and copyright information in PMC

Comment in

References

    1. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ. 2002;324:387–390. - PMC - PubMed
    1. DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL. Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf Health Care. 2004;13:251–254. - PMC - PubMed
    1. Galhotra S, DeVita MA, Simmons RL, Dew MA. Mature rapid response system and potentially avoidable cardiopulmonary arrests in hospital. Qual Saf Health Care. 2007;16:260–265. - PMC - PubMed
    1. Jones D, Bellomo R, Bates S, et al. Long term effect of a medical emergency team on cardiac arrests in a teaching hospital. Crit Care. 2005;9:R808–R815. [Epub 2005 November 16] - PMC - PubMed
    1. Offner PJ, Heit J, Roberts R. Implementation of a rapid response team decreases cardiac arrest outside of the intensive care unit. J Trauma. 2007;62:1223–1227. discussion 7–8. - PubMed

Publication types