• Bianca J Levkovich, Gordon Bingham, Judit Orosz, Cooper D J Jamie DJJ Intensive Care Unit, The Alfred, Melbourne, Victoria, Australia; Australia and New Zealand Intensive Care Research Centre, School of Public Health an, Carl M Kirkpatrick, Michael J Dooley, and Daryl A Jones.
• Alfred Health, Melbourne, Victoria, Australia; Centre for Medicines Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Safer Care Victoria, Melbourne, Victoria, Australia. Electronic address: bianca.levkovich@monash.edu.
• Resuscitation. 2019 Dec 1; 145: 75-78.

AimThe contribution of adverse medication events to clinical deterioration is unknown. This study aimed to determine the frequency and nature of rapid response system (RRS) calls that clinicians perceived were medication-related using RRS quality arm data.MethodsAnalysis of routine data prospectively collected by clinicians responding to RRS calls in an Australian acute tertiary academic hospital.ResultsBetween January 2013 and June 2017, 12,221 adult patients triggered the RRS for 25,906 medical emergency team (MET) and 512 code blue calls. Clinicians identified 433 medication-related RRS calls (1.6%) involving 406 patients (3.3%). These included 418 MET calls (1.3 medication-related MET calls per 1000 admissions) and 15 code blue calls (0.045 medication-related code blue calls per 1000 admissions). Medication-related calls occurred earlier in the admission (p = 0.002) and were more common for patients triggering multiple calls during the same admission (p < 0.001), compared to non-medication-related calls. Medication-related calls most commonly were triggered by low blood pressure (38.3%) and involved cardiovascular (43.0%) and nervous system medications (36.0%). Dose-related toxicity (n = 178) was the most frequent adverse medication event contributing to medication-related calls.ConclusionOne in 30 patients triggering a RRS call experienced medication-related clinical deterioration, most often due to dose related toxicity of cardiovascular system medications. The perceived frequency and potential preventability of this medication-related harm suggest further research is required to increase recognition of medication-related RRS calls by responding clinicians and to reduce the incidence.Copyright © 2019 Elsevier B.V. All rights reserved.

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