Study urges stepped-up response at youth hospitals

Study urges stepped-up response at youth hospitals
CHICAGO (Reuters) - Deploying standby emergency responseteams in children's hospitals could have a dramatic impact ondeath rates, researchers reported on Tuesday.
Some experts have recommended such teams for patients notin intensive care in adult and children's hospitals; butstudies have been inconsistent on whether they actually cutdeath rates in juvenile settings, a team from Lucile PackardChildren's Hospital and the Stanford University School ofMedicine said.
Their report, published in this week's Journal of theAmerican Medical Association, found that adding a rapidresponse team to work outside of intensive care units producedan 18 percent drop in the death rate, and about a 70 percentdecline in the rate of cardiac and respiratory arrests.
"The potential implications of these findings on nationalmortality rates for children are dramatic," the report said.
"Future research should focus on replicating these findingsin other pediatric inpatient settings, including settings wherechildren are treated in predominantly adult-focused hospitals,"it added.
Such teams consist of medical personnel with intensive careunit training who are available around the clock to rush to theaid of patients in the general hospital population whoseconditions appear to be deteriorating.
"Even in the hospital, sick children can deteriorate soquickly," said Dr. Paul Sharek, who led the study. "They don'thave the energy reserves or muscle mass that most adultpatients have."
In the Stanford study the teams were made availablebeginning in 2005 to proactively respond at the first sign oftrouble rather than waiting for further observations or alife-threatening development.
Once a child's heart or breathing stops "the odds oflong-term survival are pretty small," Sharek said.
"However, there's often a period of about six to eighthours when a child who might later (have trouble) begins toshow subtle signs of distress. If we can intervene early inthis process, the child is far more likely to improve than ifwe simply monitor and maintain the same approach to treatment,"he added.
The researchers said some of the cases responded to weretriggered simply because the child's caretaker or a parent feltsomething was not quite right, rather than a change in anyvital sign measurement.
"Despite the fact that (response teams) had never beenshown to decrease mortality in hospitalized children, wedecided to take a chance on this," Sharek said, adding that histeam was "excited about the results."
(Reporting by Michael Conlon; Editing by Maggie Fox andDavid Wiessler)