{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:31:03Z","timestamp":1790220663239,"version":"4.1.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Objectives:<\/jats:title>\n Despite improvements in the management of in-hospital cardiac arrest over the past decade, in-hospital cardiac arrest continues to be associated with poor prognosis. This has led to the development of rapid response systems, hospital-wide efforts to improve patient outcomes by centering on prompt identification of decompensating patients, expert clinical management, and continuous quality improvement of processes of care. The rapid response system may include cardiac arrest teams, which are centered on identification and treatment of patients with in-hospital cardiac arrest. However, few evidence-based guidelines exist to guide the formation of such teams, and the degree of their variation across the United States has not been well described.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Descriptive cross-sectional, internet-based survey.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Cohort of preidentified clinicians involved in their hospital\u2019s adult rapid response system across the United States.<\/jats:p>\n <\/jats:sec>\n \n Subjects:<\/jats:title>\n Clinicians who had been identified by study team members using personal and professional contacts over a 7-month period from June 2018 to December 2018.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n An 80-item survey was developed by the investigators. It sought information on the afferent (identification and notification of providers) and efferent (response of providers to patient) limbs of the rapid response system, as well as management of patients post in-hospital cardiac arrest.<\/jats:p>\n <\/jats:sec>\n \n Measurements and Main Results:<\/jats:title>\n One-hundred fourteen surveys were distributed. Of these, 109 (96%) were completed. Six were duplicates and were excluded, leaving a total of 103 surveys from 103 hospitals in 30 states. Seventy-six percent of hospitals were academic, 30% were large hospitals (> 750 inpatient beds), and 58% had large ICUs (> 50 ICU beds). We found wide variation in the structure and function in both the afferent and efferent limbs of the rapid response system. The majority of hospitals had a rapid response team and a cardiac arrest team. Most rapid response teams contained a provider, a critical care nurse, and a respiratory therapist. In hospitals with training programs in internal medicine, anesthesia, emergency medicine, or critical care, 45% of rapid response teams and 75% of cardiac arrest teams were led by trainees, with inconsistent attending presence. Targeted temperature management and coronary catheterization were widely used post in-hospital cardiac arrest, but indications varied considerably.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n We have demonstrated substantial variation in the structure and function of rapid response systems as well as in management of patients during and after in-hospital cardiac arrest.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/cce.0000000000000031","type":"journal-article","created":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T04:42:46Z","timestamp":1565239366000},"page":"e0031","source":"Crossref","is-referenced-by-count":17,"title":["Rapid Response and Cardiac Arrest Teams: A Descriptive Analysis of 103 American Hospitals"],"prefix":"10.1097","volume":"1","author":[{"given":"Oscar J. L.","family":"Mitchell","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, New York School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline W.","family":"Motschwiller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, New York School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, New York School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren A.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cedars Sinai, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Nichol","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, WA."},{"name":"Department of Emergency Medicine, University of Washington, Seattle, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Evans","sequence":"additional","affiliation":[{"name":"Medical Director of Critical Care, Bellevue Hospital, New York School of Medicine, New York, NY."},{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikramjit","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York School of Medicine, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,8]]},"reference":[{"key":"R1-20230728","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1001\/jama.299.7.785","article-title":"Survival from in-hospital cardiac arrest during nights and weekends.","volume":"299","author":"Peberdy","year":"2008","journal-title":"JAMA"},{"key":"R2-20230728","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.resuscitation.2014.04.002","article-title":"Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.","volume":"85","author":"Nolan","year":"2014","journal-title":"Resuscitation"},{"key":"R3-20230728","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.resuscitation.2017.10.023","article-title":"Long-term survival trends of medicare patients after in-hospital cardiac arrest: Insights from Get With The Guidelines-Resuscitation\u00ae.","volume":"123","author":"Thompson","year":"2018","journal-title":"Resuscitation"},{"key":"R4-20230728","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1378\/chest.98.6.1388","article-title":"Clinical antecedents to in-hospital cardiopulmonary arrest.","volume":"98","author":"Schein","year":"1990","journal-title":"Chest"},{"key":"R5-20230728","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0300-9572(98)00056-2","article-title":"Can some in-hospital cardio-respiratory arrests be prevented? 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