1.Rapid training of non-intensivists using an online critical care course during COVID-19.
Hui Zhong CHAI ; Constance Wei Shan TEO ; Lit Soo NG ; Sandra Li Yan HUI ; Duu Wen SEWA ; Ghee Chee PHUA ; Jolin WONG ; Carrie Kah Lai LEONG ; Ken Junyang GOH
Annals of the Academy of Medicine, Singapore 2021;50(6):503-507
2.Outcomes of second-tier rapid response activations in a tertiary referral hospital: A prospective observational study.
Ken Junyang GOH ; Hui Zhong CHAI ; Lit Soo NG ; Joanna PHONE KO ; Deshawn Chong Xuan TAN ; Hui Li TAN ; Constance Wei Shan TEO ; Ghee Chee PHUA ; Qiao Li TAN
Annals of the Academy of Medicine, Singapore 2021;50(11):838-847
INTRODUCTION:
A second-tier rapid response team (RRT) is activated for patients who do not respond to first-tier measures. The premise of a tiered response is that first-tier responses by a ward team may identify and correct early states of deterioration or establish goals of care, thereby reducing unnecessary escalation of care to the RRT. Currently, utilisation and outcomes of tiered RRTs remain poorly described.
METHODS:
A prospective observational study of adult patients (age ≥18 years) who required RRT activations was conducted from February 2018 to December 2019.
RESULTS:
There were 951 consecutive RRT activations from 869 patients and 76.0% patients had a National Early Warning Score (NEWS) ≥5 at the time of RRT activation. The majority (79.8%) of patients required RRT interventions that included endotracheal intubation (12.7%), point-of-care ultrasound (17.0%), discussing goals of care (14.7%) and intensive care unit (ICU) admission (24.2%). Approximately 1 in 3 (36.6%) patients died during hospitalisation or within 30 days of RRT activation. In multivariate analysis, age ≥65 years, NEWS ≥7, ICU admission, longer hospitalisation days at RRT activation, Eastern Cooperative Oncology Group performance scores ≥3 (OR [odds ratio] 2.24, 95% CI [confidence interval] 1.45-3.46), metastatic cancer (OR 2.64, 95% CI 1.71-4.08) and haematological cancer (OR 2.78, 95% CI 1.84-4.19) were independently associated with mortality.
CONCLUSION
Critical care interventions and escalation of care are common with second-tier RRTs. This supports the need for dedicated teams with specialised critical care services. Poor functional status, metastatic and haematological cancer are significantly associated with mortality, independent of age, NEWS and ICU admission. These factors should be considered during triage and goals of care discussion.
Adolescent
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Adult
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Aged
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Critical Care
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Hospital Mortality
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Hospital Rapid Response Team
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Humans
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Prospective Studies
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Tertiary Care Centers
4.Oral Presentation – Clinical and Translational Research
Choon Hoong Chung ; Yee Lynn Soh ; Thinaesh Manoharan ; Arwind Raj ; Dulmini Perera ; Htoo Htoo Kyaw Soe ; Nan Nitra Than ; Lilija Bancevica ; Žanna Kovalova ; Dzintars Ozols ; Ksenija Soldatenkova ; Lim Pyae Ying ; Tay Siow Phing ; Wong Jin Shyan ; Andrew Steven Sinsoon ; Nursabrina Alya Ricky Ramsis ; Nina Azwina Kimri ; Henry Rantai Gudum ; Man Le Ng ; Sze Er Lim ; Hui Yu Kim ; Yee Wan Lee ; Soo Kun Lim ; Sharven Raj ; Mohd Nasir Mohd Desa ; Nurul Syazrah Anuar ; Nurshahira Sulaiman ; Hui Chin Ting ; Zhi Ling Loo ; Choey Yee Lew ; Alfand Marl F Dy Closas ; Tzi Shin Toh ; Jia Wei Hor ; Yi Wen Tay ; Jia Lun Lim ; Lu Yian Tan ; Jie Ping Schee ; Lei Cheng Lit ; Ai Huey Tan ; Shen Yang Lim ; Zhu Shi Wong ; Nur Raziana binti Rozi ; Soo Kun Lim
International e-Journal of Science, Medicine and Education 2022;16(Suppl1):7-14
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