Bibliographic Details
| Title: |
Impact of COVID-19 on inpatient clinical emergencies: A single-center experience |
| Authors: |
Oscar J.L. Mitchell, Stacie Neefe, Jennifer C. Ginestra, Cameron M. Baston, Michael J. Frazer, Steven Gudowski, Jeff Min, Nahreen H. Ahmed, Jose L. Pascual, William D. Schweickert, Brian J. Anderson, George L. Anesi, Scott A. Falk, Michael G.S. Shashaty |
| Source: |
Resuscitation Plus, Vol 6, Iss , Pp 100135- (2021) |
| Publisher Information: |
Elsevier, 2021. |
| Publication Year: |
2021 |
| Collection: |
LCC:Specialties of internal medicine |
| Subject Terms: |
Coronavirus, COVID-19, Rapid response team, Medical emergency response team, Clinical emergencies, Patient safety, Specialties of internal medicine, RC581-951 |
| More Details: |
Aim: Determine changes in rapid response team (RRT) activations and describe institutional adaptations made during a surge in hospitalizations for coronavirus disease 2019 (COVID-19). Methods: Using prospectively collected data, we compared characteristics of RRT calls at our academic hospital from March 7 through May 31, 2020 (COVID-19 era) versus those from January 1 through March 6, 2020 (pre-COVID-19 era). We used negative binomial regression to test differences in RRT activation rates normalized to floor (non-ICU) inpatient census between pre-COVID-19 and COVID-19 eras, including the sub-era of rapid COVID-19 census surge and plateau (March 28 through May 2, 2020). Results: RRT activations for respiratory distress rose substantially during the rapid COVID-19 surge and plateau (2.38 (95% CI 1.39–3.36) activations per 1000 floor patient-days v. 1.27 (0.82–1.71) during the pre-COVID-19 era; p = 0.02); all-cause RRT rates were not significantly different (5.40 (95% CI 3.94–6.85) v. 4.83 (3.86–5.80) activations per 1000 floor patient-days, respectively; p = 0.52). Throughout the COVID-19 era, respiratory distress accounted for a higher percentage of RRT activations in COVID-19 versus non-COVID-19 patients (57% vs. 28%, respectively; p = 0.001). During the surge, we adapted RRT guidelines to reduce in-room personnel and standardize personal protective equipment based on COVID-19 status and risk to providers, created decision-support pathways for respiratory emergencies that accounted for COVID-19 status uncertainty, and expanded critical care consultative support to floor teams. Conclusion: Increased frequency and complexity of RRT activations for respiratory distress during the COVID-19 surge prompted the creation of clinical tools and strategies that could be applied to other hospitals. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2666-5204 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2666520421000606; https://doaj.org/toc/2666-5204 |
| DOI: |
10.1016/j.resplu.2021.100135 |
| Access URL: |
https://doaj.org/article/2d513b56960a48599d592143e6129e5e |
| Accession Number: |
edsdoj.2d513b56960a48599d592143e6129e5e |
| Database: |
Directory of Open Access Journals |
