1 Intensive Care Unit, Monash Medical Centre,
246 Clayton Road, Clayton, Victoria, Australia 3168
2 The Ritchie Centre, Monash University, 246
Clayton Road, Clayton, Victoria, Australia 3168
3 Monash Intensive Care Research Centre, Monash
Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia 3168
4 Department of Obstetrics and Gynaecology,
Monash Health, 246 Clayton Road, Clayton, Victoria, Australia 3168
information exists regarding rapid response team (RRT) calls to obstetric
patients, despite calls for routine adoption of obstetric early warning scores.(Lewis, 2007) We sought to examine
the demographics and outcomes of intensive care unit (ICU) led rapid response
team calls to obstetric patients in a large multispecialty hospital with a
large obstetrics unit.
of calls to pregnant and post-partum patients were obtained from the hospital
RRT database. Each call was retrospectively examined looking at patient
demographics, reason for call, interventions and outcomes. Obstetric specific
escalation calls such as urgent caesarian section (Code Pink/Green: not
requiring maternal physiological instability and not involving the ICU based
team) were excluded.
calls were logged during 43 months, with 96 calls analysed (11 Code Blue, 85
Medical Emergency Team (MET) calls). 32% of calls were to women currently
pregnant. Of calls to post-partum women, 49% occurred 24 hours or more post
delivery. The commonest reason for calling the RRT was hypotension, followed by
decreased Glasgow Coma Score (GCS) and concern about patient. 69% of calls
resulted in the woman remaining on the ward, with approximately 13% of calls
necessitating direct intensive care admission. Of all women who received a RRT
call, 23% had an ICU admission at some time during their hospital stay. There
was one maternal and three neonatal deaths during the study period.
calls using standard adult physiological calling criteria appear to
successfully identify deteriorating obstetric patients. In centres that employ
specific obstetric escalation systems, generic RRT calls may provide a second
‘safety net’ for these women.