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• W2000746547 abstract "It is hard to think of an intervention in the last two decades that has been implemented in such a widespread fashion, and so effectively, but with so little evidence as Rapid Response Systems. 1 Jones D.A. DeVita M.A. Bellomo R. Rapid-response teams. N Engl J Med. 2011; 365: 139-146 Crossref PubMed Scopus (539) Google Scholar No one from an administrative, clinical or research perspective can question the underlying assumptions that underpin RRS utilization. A plethora of research articles in the 1990s and 2000s have described the risk factors for unexpected patient clinical deterioration, that eventually results in either in-hospital cardiac arrest (IHCA), unplanned Intensive Care Unit (ICU) admission from the general ward or unexpected hospital mortality. 2 Schein R.M. Hazdat N. Pena M. et al. Clinical antecedents to in-hospital-cardiopulmonary arrest. Chest. 1990; : 1388-1392 Crossref PubMed Scopus (616) Google Scholar , 3 Franklin C. Mathew J. Developing strategies to prevent in-hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994; 22: 244-247 Crossref PubMed Scopus (443) Google Scholar , 4 Smith A.F. Wood J. Can some in-hospital cardio-respiratory arrests be prevented?. A prospective survey. Resuscitation. 1998; 37: 133-137 Abstract Full Text Full Text PDF PubMed Scopus (154) Google Scholar , 5 Buist M.D. Jarmolowski E. Burton P.R. Bernard S.A. Waxman B.P. Anderson J. Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to Intensive Care. A pilot study in a tertiary-care hospital. Med J Aust. 1999; 171: 22-25 PubMed Google Scholar , 6 Hodgetts T. Kenward G. Ioannis V. Payne S. Castle N. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation. 2002; 54: 125-131 Abstract Full Text Full Text PDF PubMed Scopus (256) Google Scholar , 7 Goldhill D.R. Sumner A. Outcome of intensive care patients in a group of British intensive care units. Crit Care Med. 1998; 28: 1337-1345 Crossref Scopus (262) Google Scholar , 8 Skrifvars M.B. Nurmi J. Ikola K. Saarinen K. Castran M. Reduced survival following resuscitation in patients with documented clinically abnormal observations prior to in-hospital cardiac arrest. Resuscitation. 2006; 70: 215-222 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar , 9 Kause J. Smith G. Prytherch D. Parr M. Flabouris A. Hillman K. A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom – the ACADEMIA study. Resuscitation. 2004; 62: 275-282 Abstract Full Text Full Text PDF PubMed Scopus (451) Google Scholar , 10 Hillman K.M. Bristow P.J. Chey T. et al. Antecedents to hospital deaths. Int Med J. 2001; 31: 343-348 Crossref Scopus (297) Google Scholar The executive summary of this basic epidemiological work is that such patients do not on the whole suddenly deteriorate, arrest, die, or if they are lucky get an ICU admission with an associated high mortality rate; rather they deteriorate slowly over hours and even days, with the clinical deterioration beautifully documented in the observation chart and the written medical record. The obvious solution is to intervene in some way during this patient deterioration, with appropriate, and timely, diagnosis, treatment and if necessary, resuscitation. 6 Hodgetts T. Kenward G. Ioannis V. Payne S. Castle N. The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation. 2002; 54: 125-131 Abstract Full Text Full Text PDF PubMed Scopus (256) Google Scholar , 11 Buist M. Nguyen T. Moore G. Bernard S. Anderson J. Association between clinically abnormal bedside observations and subsequent in hospital mortality: a prospective study. Resuscitation. 2004; 62: 137-141 Abstract Full Text Full Text PDF PubMed Scopus (340) Google Scholar , 12 Goldhill D.R. McNarry A.F. Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth. 2004; 92: 882-884 Crossref PubMed Scopus (236) Google Scholar Alternatively an earlier decision about the appropriateness of resuscitation can be made with the patient and palliative options considered." @default.
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• W2000746547 title "In search of the “Holy Grail”: Will we ever prove the efficacy of Rapid Response Systems (RRS)?" @default.
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• W2000746547 doi "https://doi.org/10.1016/j.resuscitation.2014.07.007" @default.
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