The Resuscitation Officer: Responsibilities and Impact

In response to potential safety events in hospitals, the rapid response system (RRS) has been established as the forefront of patient safety. According to previous studies, worsening of symptoms and conditions was detected approximately on average 6–8 h before cardiac arrest (CA) in 40–60% of hospitalized patients (Hodgetts et al., Resuscitation, 54(2):115–123, 2002; Andersen et al., Resuscitation, 98:112–117, 2016; Smith and Wood, Resuscitation, 37(3):133–137, 1998). In these cases, the medical staff may not recognize the signs of worsening and may not provide adequate treatment in a timely manner, leading to CA. RRS is intended for all patients admitted to the general ward. RRS aims to provide early intervention to high-risk patients who exhibit sudden deterioration of conditions and prevent major organ failure and CA and ultimately improve the prognosis of admitted patients. Therefore, the rapid response team (RRT) has a different role compared to the traditional code team that provides treatment after CA occurs (Table 26.1) (Jones et al., N Engl J Med, 365(2): 139–146, 2011). The RRT evaluates a larger number of inpatients than the traditional code team. In addition, according to the RRT triggering system of each hospital, specialized personnel in the RRT, who are able to care for critically ill patients, directly assess the patient and provide appropriate interventions upon being notified of the patient’s condition (i.e., low blood pressure, tachycardia, loss of consciousness). In contrast, the traditional code teams are activated after CA occurs and directly perform cardiopulmonary resuscitation (CPR). Depending on the hospital, the RRT may also perform the role of the traditional code team; however, in general, the two teams have different purposes and characteristics (Table 26.1) (Jones et al., N Engl J Med, 365(2): 139–146, 2011). In every medical institution, the traditional code team is responsible for providing CPR to patients with CA, and the resuscitation officer (RO) and the CPR committee monitor the function of the traditional code team, manage response situations in CA patients, and provide simulation training. Herein, we describe the role of the RRT leader as the RO of RRS.