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In Reply: Drs Frost and Wise argue that a lack of sufficient training among general ward staff contributes to the success of RRT interventions. We agree that in an ideal world, all staff involved in the care of general ward patients would be sufficiently trained and capable of both recognizing and treating deteriorating patients. Fortunately, cardiorespiratory arrests remain a relatively rare event in pediatrics, an observation supported by our study. Training large numbers of staff (including part-time and full-time nurses, rotating medical and surgical residents, fellows, and attending physicians) to be proficient in the treatment of the small number of patients at immediate risk of cardiorespiratory compromise is challenging, costly, and likely to be unsuccessful given standard educational approaches.¹

For example, all general ward staff members at Lucile Packard Children's Hospital are certified in pediatric advanced life support. Yet even with regular mock code training, they rarely have the opportunity . . . [Full Text of this Article]

Paul Sharek, MD, MPH
psharek@lpch.org

Stephen J. Roth, MD, MPH
Stanford University School of Medicine
Palo Alto, California

RELATED LETTER

Cardiorespiratory Arrests and Rapid Response Teams in Pediatrics
Paul Frost and Matt P. Wise
JAMA. 2008;299(12):1423-1424.
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