Rapid Response Teams with Dr. Nada Mallick and the Cribsiders -- Part 2
Nov 15, 2023
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Dr. Nada Mallick, pediatric intensivist at Children's National Hospital, discusses the importance of rapid response teams in addressing respiratory distress and hypotension. The podcast also explores challenges in communication and collaboration during a rapid response, emphasizing the value of involving nurses and having clear plans. It concludes with gratitude and collaboration efforts.
Effective communication and inclusion of family members during rapid responses is crucial, informing and updating families even if the patient does not require ICU admission.
Conducting a thorough patient examination and hands-on assessment during rapid responses is vital, physicians should not solely rely on lab studies or vital signs.
Deep dives
Effective Communication and Inclusion of Family Members
In the podcast episode, the importance of effective communication and inclusion of family members during rapid responses is emphasized. It is highlighted that families should be informed and updated about the situation, even if the patient does not require ICU admission. Additionally, the use of interpreters for non-English speaking families is recommended to ensure clear communication and understanding.
Thorough Patient Examination and Hands-on Assessment
The podcast emphasizes the significance of conducting a thorough patient examination and hands-on assessment during rapid responses. It is stressed that physicians should not solely rely on lab studies or vital signs, but rather physically examine the patient themselves. This direct examination enables a better understanding of the patient's condition and any changes that may occur.
Do Not Hesitate to Escalate
The podcast underlines the importance of not hesitating to escalate a rapid response if necessary, whether it be calling a code or involving additional healthcare team members. Collaborative teamwork is encouraged, and it is emphasized that rapid responses are not a solitary endeavor. The primary focus should be on the well-being of the patient, and asking for help and support is essential in providing optimal care.
Value and Respect Stakeholders' Perspectives
The podcast highlights the importance of valuing and respecting the perspectives of all stakeholders involved in a rapid response, including nurses, respiratory therapists, and families. It is recommended to actively seek input from these individuals and consider their concerns and observations. This collaborative approach fosters a more comprehensive understanding of the patient's condition and helps facilitate better decision-making.
Dr. Nada Mallick is a pediatric intensivist at Children's National Hospital in Washington, DC. She has a master’s in Biochemistry and Molecular Biology from the Johns Hopkins University School of Public Health, after which she did her medical residency and chief resident year at Virginia Commonwealth University and her critical care fellowship at Children's National Hospital. Nada now serves as the physician chair for both the Pediatric Early Recognition and Resuscitation Committee and the Late Rescue Collaborative at Children’s National.
The Cribsiders is a pediatric medicine podcast composed of a national network of students, residents and clinician educators from across the country and multiple institutions. On the show we “curbside” the experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge and a weight-based dosing of fun.
Learning Objectives: By the end of this series, listeners should be able to: 1) Describe techniques for diagnosis of historically oppressed groups 2) Describe acute stabilization of impending hypoxemic respiratory failure from a complicated pneumonia. 3) Discuss workup for a patient with undifferentiated shock. 4) Describe options for ICU support for a patient who does not meet ICU criteria.
References
Jones DA, DeVita MA, Bellomo R. Rapid-response teams. N Engl J Med. 2011;365(2):139-146. doi:10.1056/NEJMra0910926
Levin AB, Brady P, Duncan HP, Davis AB. Pediatric Rapid Response Systems: Identification and Treatment of Deteriorating Children. Curr Treat Options Pediatr. 2015;1(1):76-89. doi:10.1007/S40746-014-0005-1/TABLES/1
Gold DL, Mihalov LK, Cohen DM. Evaluating the Pediatric Early Warning Score (PEWS) system for admitted patients in the pediatric emergency department. Acad Emerg Med. 2014;21(11):1249-1256. doi:10.1111/acem.12514
Tews MC, Liu JM, Treat R. Situation-Background-Assessment-Recommendation (SBAR) and Emergency Medicine Residents’ Learning of Case Presentation Skills. J Grad Med Educ. 2012;4(3):370-373. doi:10.4300/JGME-D-11-00194.1
Gross CJ, Porter JJ, Lipsett SC, Monuteaux MC, Hirsch AW, Neuman MI. Variation in Management and Outcomes of Children With Complicated Pneumonia. Hosp Pediatr. 2021;11(3):207-214. doi:10.1542/hpeds.2020-001800
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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.comfor detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
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