• Zachary J Berrens, Craig H Gosdin, Patrick W Brady, and Ken Tegtmeyer.
• Department of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
• Pediatr Crit Care Me. 2019 Feb 1; 20 (2): 172-177.

ObjectivesSatellite inpatient facilities of larger children's hospitals often do not have on-site intensivist support. In-house rapid response teams and code teams may be difficult to operationalize in such facilities. We developed a system using telemedicine to provide pediatric intensivist involvement in rapid response team and code teams at the satellite facility of our children's hospital. Herein, we compare this model with our in-person model at our main campus.DesignCross-sectional.SettingA tertiary pediatric center and its satellite facility.PatientsPatients admitted to the satellite facility.InterventionsImplementation of a rapid response team and code team model at a satellite facility using telemedicine to provide intensivist support.Measurements And Main ResultsWe evaluated the success of the telemedicine model through three a priori outcomes: 1) reliability: involvement of intensivist on telemedicine rapid response teams and codes, 2) efficiency: time from rapid response team and code call until intensivist response, and 3) outcomes: disposition of telemedicine rapid response team or code calls. We compared each metric from our telemedicine model with our established main campus model.Main ResultsCritical care was involved in satellite campus rapid response team activations reliably (94.6% of the time). The process was efficient (median response time 7 min; mean 8.44 min) and effective (54.5 % patients transferred to PICU, similar to the 45-55% monthly rate at main campus). For code activations, the critical care telemedicine response rate was 100% (6/6), with a fast response time (median 1.5 min). We found no additional risk to patients, with no patients transferred from the satellite campus requiring a rapid escalation of care defined as initiation of vasoactive support, greater than 60 mL/kg in fluid resuscitation, or endotracheal intubation.ConclusionsTelemedicine can provide reliable, timely, and effective critical care involvement in rapid response team and Code Teams at satellite facilities.

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