Letter to the Editor
Rapid Response Teams: a great opportunity
Equipos de Respuesta Rápida: Una gran oportunidad
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Salinas, A. Abella, A. Cuadrado, F. Gordo" "autores" => array:4 [ 0 => array:3 [ "nombre" => "I." "apellidos" => "Salinas" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Abella" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Cuadrado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:4 [ "nombre" => "F." "apellidos" => "Gordo" "email" => array:1 [ 0 => "fgordo5@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Universitario del Henares, Coslada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Equipos de Respuesta Rápida: Una gran oportunidad" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with interest the article published by Jung B et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> which shows good results obtained after the implementation of a rapid response team (RRT), led by an intensivist physician who has been notified after really critical clinical parameters have been established. It also highlights the deployment method using progressive modules up to its beginning: education, advertising and bedside simulation. It is observed a reduction in total mortality from 39.6 to 34.6 per 1000 hospital admissions (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.012), 1.5 lives saved/week; which is an excellent result, as well as reducing organic failure at ICU admission. It will undoubtedly lead to a better prognosis of those patients admitted to the ICU.</p><p id="par0010" class="elsevierStylePara elsevierViewall">However, we consider it essential that RRT are reinforced by gain opportunity, especially in time-dependent pathologies, involving a performance immediately after early detection of patients at risk, not only critically ill, by employing automated detection systems.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> In our experience (“without walls ICU model”, with progressive introduction in our center since 2008) the focus of this early detection must be multidisciplinary, emphasizing the use of technological systems such as, in this case, a computer application.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">To this proactive early detection of severity in the hospital, and intensivist performance in conventional ward and emergency services, in addition to clinical parameters, we add analytical parameters, which are altered with early physiological changes that are considered of interest to detect potentially serious diseases on patients. Rapid intervention can improve prognosis and reduce the occurrence of complications. These intelligent systems are associated with organizational changes in healthcare, both within and outside the ICU. Intensivist physician is the one who makes intervention without waiting to be called and, what is more, this is made in a collaborative way with different specialties. This involves early detection within a comprehensive security plan in healthcare. This model of care is aimed to good results even in off-hours periods, in which it is shown a worse prognosis for patients.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Although there is an important work to do in the detection of severity and early intervention on patients at organ failure risk, it is important to stress that this work must be adapted to the circumstances of each institution and must include, as in the center studied in the article, training in severity detection, to which we add multidisciplinary work in the whole clinical process, managing efficient implementation of technological systems to analyze those physiological parameters monitored.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid response team and hospital mortality in hospitalized patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Jung" 1 => "A. Daurat" 2 => "A. De Jong" 3 => "G. Chanques" 4 => "M. Mahul" 5 => "M. Monnin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-016-4254-2" "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2016" "volumen" => "42" "paginaInicial" => "494" "paginaFinal" => "504" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26899584" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes associated with the nationwide introduction of rapid response systems in The Netherlands" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "For the Cost and Outcomes of Medical Emergency Teams Study Group" "etal" => true "autores" => array:6 [ 0 => "J. Ludikhuize" 1 => "A.H. Brunsveld-Reinders" 2 => "M.G.W. Dijkgraaf" 3 => "S.M. Smorenburg" 4 => "S. de Rooij" 5 => "R. Adams" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0000000000001272" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2015" "volumen" => "43" "paginaInicial" => "2544" "paginaFinal" => "2551" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26317569" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intensive care unit without walls: seeking patient safety by improving the efficiency of the system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Gordo" 1 => "A. Abella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2014.02.001" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2014" "volumen" => "38" "paginaInicial" => "438" "paginaFinal" => "443" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24661919" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ICU without walls project. Effect of the early detection of patients at risk" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Abella Álvarez" 1 => "I. Torrejón Pérez" 2 => "V. Enciso Calderón" 3 => "C. Hermosa Gelbard" 4 => "J.J. Sicilia Urban" 5 => "M. Ruiz Grinspan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2012.08.006" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "12" "paginaFinal" => "18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23059055" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii: S0210-5691" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect upon mortality of the extension to holidays and weekends of the ICU without walls project. A before-after study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Abella" 1 => "V. Enciso" 2 => "I. Torrejón" 3 => "C. Hermosa" 4 => "T. Mozo" 5 => "R. Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2015.09.001" "Revista" => array:4 [ "tituloSerie" => "Med Intensiva" "fecha" => "2015" "paginaInicial" => "00196" "paginaFinal" => "205" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02105691/0000004100000006/v1_201707211500/S0210569116300493/v1_201707211500/en/main.assets" "Apartado" => array:4 [ "identificador" => "57221" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004100000006/v1_201707211500/S0210569116300493/v1_201707211500/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116300493?idApp=WMIE" ]
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