Time de resposta rápida nas unidades de terapia intensiva e internação de um hospital de grande porte de Belo Horizonte/MG: um estudo observacional

Karina de Freitas Santos; Bruna Ferreira Cícero Lima

doi:10.47456/rbps.v24i3.38207

Authors

Karina de Freitas Santos
Bruna Ferreira Cícero Lima Santa Casa de Misericórdia de Belo Horizonte https://orcid.org/0000-0001-6053-3392

DOI:

https://doi.org/10.47456/rbps.v24i3.38207

Keywords:

Hospital rapid response team, Clinical deterioration, Patient safety

Abstract

Introduction:
The rapid response team (RRT) is a system intended for the care of patients in aggravating circumstances outside a more complex and specialized environment to meet urgent situations. Objectives: To analyze the attendance data of a rapid response team of a large philanthropic hospital in Belo Horizonte-MG. Methods: This is a retrospective, observational and descriptive study that was carried out through the analysis of care data and monitoring of a Quick Response Team of a large philanthropic hospital, with more than a thousand beds 100% Unified Health System, in Belo Horizonte-MG, between January 2017 and June 2018. Results: The results of this work showed that during the study period there were 1,942 code yellow calls. The activities developed by RRT professionals were: guidelines, being more frequent in relation to diagnostic investigation, respiratory support, hemodynamic monitoring; the performance of procedures, mainly orotracheal intubation and therapies such as volume replacement with crystalloid solutions, use of vasoactive drugs, antimicrobials, analgesics, oxygen and sedatives. Conclusion: This work demonstrates the activities of a rapid response team within a hospital, its importance in numbers, as well as the epidemiological criteria of patients treated by this team. In addition, it allows for a discussion on better communication/standardization and implementation of protocols in order to benefit greater professional autonomy for nurses, as well as to act quickly in an adversity.

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References

Mezzaroba AL, Tanita MT, Festii J, Carrilho CMDM, Cardoso LTQ, Grion CMC. Avaliação de 5 anos de atuação de um time de resposta rápida liderado por médico intensivista em hospital universitário. Rev Bras Ter Intensiva. [Internet]. 2016 [acesso em: 23 abr. 2018];28(3):278- 84. Disponível em: https://www.scielo.br/j/rbti/a/ Vx3yGXzYhsnQrNjkbZTHk8g/abstract/?lang=pt

Rocha HAL, Alcântara ACC, Rocha SGMO, Toscano CM. Efetividade do uso de times de resposta rápida para reduzir a ocorrência de parada cardíaca e mortalidade hospitalar: uma revisão sistemática e metanálise. Rev Bras Ter Intensiva. [Internet]. 2018 [acesso em: 23 abr. 2018];30(3):366- 75. Disponível em: https://www.scielo.br/j/rbti/a/ kGmsC5PjhfVVqNd3bPStVRN/?format=pdf&lang=pt

Lee BY, Hong SB. Rapid response systems in Korea. Acute Crit Care. [Internet]. 2019 May [cited 2022 Sep 15]; 34(2):108-116. Available from: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC6786673/

Viana MV, Nunes DSL, Teixeira C, Vieira SRR, Torres G, Brauner JS, et al. Changes in cardiac arrest profiles after the implementation of a Rapid Response Team. Rev Bras Ter Intensiva. [Internet]. 2021 Jan-Mar; 33(1):96- 101. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC8075345/

Walco JP, Mueller DA, Lakha S, Weavind LM, Clifton JC, Freundlich RE. Etiology and Timing of Postoperative Rapid Response Team Activations. J Med Syst [Internet]. 2021 [cited 2019 Apr 23];45,82. Available from: https:// link.springer.com/article/10.1007/s10916-021-01754-3

Mankidy B, Howard C, Morgan CK, Valluri KA, Giacomino B, Marfil E, et al. Reduction of in-hospital cardiac arrest with sequential deployment of rapid response

team and medical emergency team to the emergency department and acute care wards. PLoS One. [Internet]. 2020 Dec 1 [cited 2022 Sep 15];15(12):e0241816. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC7707602/

Petersen JA, Rasmussen LS, Rydahl-Hansen S. Barriers and facilitating factors related to use of early warning score among acute care nurses: a qualitative study. BMC Emergency Medicine [Internet]. 2017 [cited 2018 Apr 23];17:36. Available from: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC5710111/pdf/12873_2017_ Article_147.pdf

Durantez-Fernández C, Martín-Conty JL, Medina- Lozano E, Mohedano-Moriano A, Polonio-López B, Maestre-Miquel C, et al. Early detection of intensive care needs and mortality risk by use of five early warning scores in patients with traumatic injuries: An observational study. Intensive & Critical Care Nursing [Internet]. 2021 [cited 2018 Apr 23];67:103095. Available from: https://www.sciencedirect.com/science/article/pii/ S0964339721000847?via%3Dihub

Shappell C, Snyder A, Edelson DP, Churpek MM. Predictors of In-Hospital Mortality After Rapid Response Team Calls in a 274 Hospital Nationwide Sample. Crit Care Med. [Internet]. 2018 Jul [cited 2022 Sep 15];46(7):1041- 1048. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC6044728/

Brasil. Resolução nº 2.271, de 14 de fevereiro de 2020. Define as unidades de terapia intensiva e unidades de cuidado intermediário conforme sua complexidade e nível de cuidado, determinando a responsabilidade técnica médica, as responsabilidades éticas, habilitações e atribuições da equipe médica necessária para seu adequado funcionamento. Diário Oficial da União [Internet], 14 de fevereiro de 2020;77(1):90. Disponível em: https:// www.in.gov.br/web/dou/-/resolucao-n-2.271-de-14-de-fevereiro-de-2020-253606068

Brito ALF, Miranda DG, Lopes FRS, Fraitas GAF, Barroso HS, Gonçalves RCB, et al. Protocolo Clínico: Diagnóstico e manejo inicial da sepse [Internet]. Belo Horizonte: Santa Casa de Misericórdia de Belo Horizonte; 2018. Disponível em: http://www.santacasabh.org.br/app/ webroot/files/uploads/Sepse.pdf

Jones CM, Butler KJ, Cox KR. TIGER Team: Rapid Response at the University of Missouri. Mo Med. [Internet]. 2019 Jul-Aug [cited 2022 Sep 19];116(4):297- 302. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC6699818/

Gong XY, Wang YG, Shao HY, Lan P, Yan RS, Pan KH, et al. A rapid response team is associated with reduced overall hospital mortality in a Chinese tertiary hospital: a 9-year cohort study. Ann Transl Med. [Internet]. 2020 Mar [cited 2022 Sep 19];8(6):317. Available from: https://www. ncbi.nlm.nih.gov/pmc/articles/PMC7186685/

Reardon PM, Seely AJE, Fernando SM, Didcote S, Strachan I, Baudino J-L et al. Can Early Warning Systems Enhance Detection of High Risk Patients by Rapid Response Teams?. Journal of Intensive Care Medicine [Internet]. 2021 [cited 2019 Apr 23];36(5):542-9. Available from: https:// journals.sagepub.com/doi/10.1177/0885066620978140

Kang BJ, Hong SB, Jeon K, Lee SM, Lee DH, Moon JY, et al. Rapid Response System Should Be Enhanced at Non-general Ward Locations: a Retrospective Multicenter Cohort Study in Korea. J Korean Med Sci. [Internet] 2021 Jan [cited 2019 Apr 23];36(2):e7. Available from: https:// doi.org/10.3346/jkms.2021.36.e7

Ahn JH, Jung YK, Lee J-R, Oh YN, Oh DK, Huh JW et al. Predictive powers of the Modified Early Warning Score and the National Early Warning Score in general ward patients who activated the medical emergency team. PLoS ONE [Internet]. 2020 [cited 2019 Apr 23];15(5):e0233078. Available from: https://journals.plos.org/plosone/article/ file?id=10.1371/journal.pone.0233078&type=printable

Park J, Lee YJ, Hong S-B, Jeon K, Moon JY, Kim JS, et al. The association between hospital length of stay before rapid response system activation and clinical outcomes: a retrospective multicenter cohort study. Respir Res [Internet]. 2021 [cited 2019 Apr 23];22:60. Available from: https://respiratory-research.biomedcentral.com/ track/pdf/10.1186/s12931-021-01660-9.pdf

Ko BS, Lim TH, Oh J, Lee Y, Yun InA, Yang MS, et al. The effectiveness of a focused rapid response team on reducing the incidence of cardiac arrest in the general ward. Medicine [Internet]. 2020 [cited 2019 Apr 23];99:10. Available from: https://journals.lww.com/md-journal/Fulltext/2020/03060/The_effectiveness_of_a_focused_ rapid_response_team.6.aspx

Taniguchi LU, Pires EM, Vieira Jr. JM, Azevedo LC. Critérios para síndrome de resposta inflamatória sistêmica e predição de mortalidade hospitalar em pacientes críticos: estudo retrospectivo de coorte. Rev Bras Ter Intensiva. [Internet]. 2017 [acesso em: 23 abr. 2019];29(3):317-24. Disponível em: http://www.scielo.br/pdf/rbti/v29n3/0103- 507X-rbti-20170047.pdf

Almeida MC, Portela MC, Paiva EP, Guimarães RR, Pereira Neto WC, Cardoso PR. Implantação de um time de resposta rápida em um grande hospital filantrópico brasileiro: melhora na qualidade dos cuidados de emergência por meio do ciclo Planejar-Fazer-Estudar-Agir. Rev Bras Ter Intensiva. [Internet]. 2019 [acesso em: 23 abr. 2019];31(2):217- 226. Disponível em: https://www.scielo.br/j/rbti/a/ D7WYs6x4t6xssvSv9hHkqLy/?format=pdf&lang=pt