# Rapid Response Teams in low and middle-income countries: a scoping review

## TL;DR

This paper reviews how Rapid Response Teams are used in low and middle-income countries to help patients whose health is worsening, finding limited evidence and a need for more research.

## Contribution

The study provides the first comprehensive scoping review of Rapid Response Teams in low- and middle-income countries, highlighting gaps in evidence and implementation.

## Key findings

- Most studies on Rapid Response Teams in low- and middle-income countries come from Brazil, India, and Turkey.
- The majority of studies focused on mortality and code blue incidence as outcomes.
- Evidence on Rapid Response Teams in these settings is limited and lags behind high-income countries.

## Abstract

Rapid Response Teams have been widely implemented in high-income countries and play a crucial role in the early identification and management of clinically deteriorating patients. However, their implementation in low and middle-income settings has not been adequately described. Our goal was to map the current evidence in this setting.

We conducted a scoping review to map the published literature about Rapid Response Teams in low- and middle-income countries, according to year of publication, study type, team composition, reported outcomes, and potential roles of the team.

After screening 6,679 studies, 52 fulfilled eligibility criteria: 36 full-text studies and 16 conference abstracts. Most of the studies were from Brazil (51.2%), followed by India (19.2%) and Turkey (7.7%), with the two earliest reports being conference abstracts published in 2009. The predominant design was before-and-after studies (20; 38.4%), followed by cohort studies (16; 30.8%). An intensive care unit physician was always a member of the Rapid Response Teams in 55.9% of the studies and an intensive care unit nurse in 23.5%. The number of Rapid Response Teams calls in the before-and-after studies ranged from 2.39 to 124 per 1,000 admissions. Reported outcomes varied, with most studies focusing on mortality (26, 50%) and code blue incidence (21; 40.4%). Four (7.7%) studies reported an active role of Rapid Response Teams in goals of care discussions.

We found that evidence on Rapid Response Teams in low- and middle-income countries remains limited, with a time lag in publications compared to high-income countries. Our findings highlight the need for further studies and policy initiatives to evaluate the effectiveness of implementing Rapid Response Teams in resource-constrained settings.