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ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 41-45

Experience gained by emergency medicine residents as members of the rapid response team


1 Department of Emergency Medicine, St. Luke's University Health Network, Bethlehem, PA, USA
2 Department of Critical Care, Mt. Sinai Medical Center, New York, USA

Correspondence Address:
Rebecca Jeanmonod
St. Luke's University Health Network, 801 Ostrum St, Bethlehem, PA 18015
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2455-5568.183336

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Objectives: Rapid response teams (RRTs) are multidisciplinary teams designed to respond to unstable patients within the hospital. Given the acuity of these patient encounters, this offers an opportunity to expose emergency medicine (EM) residents to a high concentration of experiences that are important for their training. This study was a retrospective observational study quantifying the value to an EM resident performing primary airway assessments while participating on the RRT. Methods: The study site is a community trauma center that hosts an EM residency. All RRT logs from 2008 to 2013 were reviewed by trained data abstractors. Abstractors recorded interventions performed by EM residents, which we a priori identified as endotracheal intubation, ordering of noninvasive positive pressure ventilation (NIPPV), placement of central vascular access, placement of intraosseous access, and/or ordering of resuscitative medications. Data were entered into a standardized Excel spreadsheet where abstractors chose from a closed list of possibilities and were analyzed with descriptive statistics. Results: One thousand nine hundred and eighty-four encounters were reviewed. 53.9% of patients had advancement in their level of care. 29.2% of rapid responses resulted in patient intubation and 17.8% of patients required initiation of NIPPV. In addition, 1.6% of patients required immediate placement of a central line and 0.4% required placement of intraosseous access. EM residents involved in the RRT ordered resuscitative medications in 17.2% of encounters. Conclusions: EM resident involvement on RRTs provides them exposure to a number of critical encounters and advanced procedures that are essential for their EM training. The following core competencies are addressed in this article: This article addresses the ACGME milestones pertaining to patient care as well as procedural skills.


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