The role of Rapid Response Teams during in-hospital sudden cardiac arrest – a retrospective cohort study

INTRODUCTION: Sudden Cardiac Arrest (SCA) is a condition in which it is crucial to quickly start resuscitation measures. In hospitals, Advanced Life Support (ALS) is the responsibility of medical personnel, usually operating as a Medical Emergency Team (MET) or Critical Care Response Team (CCRT). During medical duty, a Rapid Response Team (RRT) is selected from the Hospital Emergency Department (ER) or the Anesthesiology and Intensive Care Unit (ICU). The aim of the study was to determine the effect of RRT activities on the outcome of resuscitation during in-hospital SCA and to identify factors of increased risk of such an event. MATERIALS AND METHODS: The analysis included 87 SCA and resuscitation protocols prepared in a voivodeship (state) hospital in central Poland in 2023. Attention was paid, among other things, to the mechanism and cause of SCA, the medical actions taken by the RRT and the time it took the RRT to reach the patient. Variables were assessed in terms of short-term survival. Basic data were calculated using descriptive statistics and variable correlations. The significance level was set at p=0.05. RESULTS: The analysis included 87 calls for in-hospital cardiac arrest, of which 56 (64.37%) were men and 27 (31.03%) were women (4 cases did not specify sex). Most interventions concerned the general surgery (n=26; 29.89%), cardiology (n=20; 22.99%) and orthopedics departments (n=11; 12.64%). In the vast majority of cases (n=56; 64.37%), SCA occurred in the presence of medical staff from a given hospital department, who notified the RRT. The team arrived at the call site in an average of 3.30 minutes. The predominant procedure (n=80; 91.95%) implemented by RRT was rescue pharmacotherapy, indirect cardiac massage (n=70; 80.46%), ventilation (n=69; 79.31%), and device-assisted airway management (n=66; 75.86%). The implementation of respiratory therapy by RRT proved to be significant in achieving ROSC (p=0.003). In most patients, asystole or PEA was observed as the mechanism of SCA (n=76; 87.36%). Before the arrival of the Emergency Medical Team, defibrillation was performed in 7 (8.05%) cases, and after arrival in 11 (12.64%) cases. Spontaneous circulation return was achieved in 42 patients (48.28%). CONCLUSIONS: Rapid Response Teams play an important role in providing medical assistance to patients who experience a sudden deterioration in their condition or cardiac arrest during hospitalization, especially in the surgical, cardiology and orthopedic departments. Emergency medical services arrive at the scene of the call quickly, most often implementing pharmacotherapy, chest compressions, ventilation and instrument-based airway opening management. Despite these efforts, more than half of the patients did not survive SCA.