Introduction: Rapid Response System (RRS) was implemented worldwide to limit or prevent intrahospital cardiac arrests as many are preceded by signs of instability. After-hour care remain a concern in healthcare. RRS was implemented in 2010 at our hospital.  

Aims: To determine the effectiveness and sustainability of RRS implementation to the intra-hospital cardiac arrest rates over 10-year period after giving time for the system to mature.

Methods: Retrospective observational study of a prospectively collected data on all RRS calls activated between January 1, 2013, to December 31, 2022. We included all in-patients with age >16 years who had an RRS-call activated and suffered cardiac arrest during their hospitalization. RRS-calls with pre-exiting not for resuscitation (NFR) orders, non-admitted patients, in intensive care unit or emergency department were excluded.  We investigated their frequency, initial rhythm noted, time, total duration and all cause in-hospital mortality of these calls.

Results: 20399 RRS-calls were recorded in the study period. The number significantly increased from 1570 calls/year in 2013 to 2564 calls/year in 2022 . The proportion of concurrent RRS-calls also more than doubled. We excluded 4004 RRS-call episodes from analysis. The median age was 69 years, 47.47% were females. The cardiac arrest occurred more during the after-hours. The proportion of cardiac arrest each year steadily reduced from 3.2% in 2013 to 1.4% in 2021 and 1.8% in 2022. Overall, the mortality for non-shockable rhythms was high. 

Conclusion: Our study confirmed despite there is significant increase in the frequency of RRS calls, there was a steady decrease in number of intrahospital cardiac arrest rates.

Significance: This indicated effective implementation and sustainability of the mature RRS. 

 
Dr Manoj Y Singh, Kristen Douglass, Jo Lindbek, Anil Ramnani, Tina Xu,  Krishna Karpe

Canberra Health Services, Garran, ACT, 2605