Crit Care Resusc
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Most studies of the rapid response team (RRT) investigate the effect of introducing an RRT on outcomes of all hospitalised patients. Less information exists on RRT patient epidemiology, or changes in RRT call numbers with time. ⋯ Annual RRT calls are increasing in many Australian hospitals, and now affect more than 14 700 patients annually. Inhospital mortality of RRT patients is about 25%, and about 20% of patients who die in hospital are reviewed by the RRT. Further research is needed to understand the reason for the high inhospital mortality of RRT patients.
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Randomized Controlled Trial
The Protocolised Management in Sepsis (ProMISe) trial statistical analysis plan.
The Protocolised Management in Sepsis (ProMISe) trial is an open, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early, goal directed, protocolised resuscitation compared with usual resuscitation for patients presenting to emergency departments (EDs) in the United Kingdom with early signs of severe sepsis or septic shock. The rationale for the ProMISe trial derives from a single-centre United States RCT that reported a reduction in hospital mortality from 46.5% to 30.5%. ⋯ In keeping with best practice, we have developed a statistical analysis plan for the ProMISe trial and place it in the public domain before inspecting data from the trial.
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Despite extensive work to improve early recognition of and response to abnormal vital signs, a failure or delay in response to clinical deterioration by activating a medical emergency team (MET) can affect patient safety. ⋯ Despite one in seven patients fulfilling MET criteria, MET activation occurred infrequently. The presence of MET criteria was associated with a doubling of the hospital LOS. Escalation of care in response to detection of MET criteria fulfillment was variable. Further research tracking patient management is needed to understand the decision-making process that occurs in the presence of clinical deterioration.
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Multicenter Study
Sodium administration in critically ill patients in Australia and New Zealand: a multicentre point prevalence study.
Inadvertent sodium administration in excess of recommended daily requirements has been reported during routine care of critically ill patients. ⋯ This point prevalence study suggests that sodium administration in excess of recommended daily requirements may be common in Australia and New Zealand ICUs. The main sodium source was IV maintenance fluids, followed by fluid boluses and drug boluses.