Welcome to the Pediatric Critical Care Unit at McMaster. During your rotation you are likely to be involved in a PACE activation so below is a brief introduction to the PACE team and an outline of the PCCU resident responsibilities during a PACE activation.

PACE is the McMaster Children’s Hospital Medical Emergency Team similar to the RACE team at the Hamilton General Hospital. PACE is an acronym for Pediatric Assessment of Critical Events. PACE can be activated by vital sign triggers, a healthcare provider concern about the patient’s status, or rarely by the patient’s family if their child deteriorates and they cannot locate their RN or other healthcare provider. The central driving philosophy behind the PACE team is earlier detection of a patient’s clinical deterioration before leading to a Code Blue, cardiac arrest or unplanned PCCU admission.

The resident who carries the PCCU Resident On-Call pager (“Peds 1000” Pager) is responsible to respond to all PACE activations with the other members of the PACE team.

Currently the team consists of a 4-person response:

  • The PACE MD, who is generally one of the pediatric intensivists or a PCCU fellow
  • The PACE RN, a PCCU RN who has received additional MET training
  • A pediatric RT
  • The PCCU resident carrying the PCCU on-call pager

When a healthcare provider needs to activate PACE they simply call Paging with their location (ward and room number). Subsequently the PACE team members listed above will all receive a page with the location of the PACE call. The team members should then make their way to the location of the call to assess the patient. The upper response time limit for all PACE members to arrive at the patient’s bedside is 15 minutes; however, if you are free to respond when the call is triggered then you should proceed to the location immediately.

The PACE RN will bring an equipment bag containing a variety of medications, equipment and monitors to deal with most urgent situations BUT does NOT contain intubation equipment or resuscitation drugs. If these are required, then a Code Blue should be activated.

The PCCU resident is required to respond to the activation and remain during the initial assessment; however, if it is determined that the patient is stable and will not require PCCU admission, then the PCCU resident may return to their previous duties leaving the PACE RN +/- the PACE MD to complete the call and accompanying documentation. You should write your name on and sign the PACE activation record prior to your departure.

Other things to know about PACE:

  • PACE is a consultative service and unless emergent treatment is required, all therapies and recommendations should be discussed with the patient’s most responsible team
  • A member of the patient’s most responsible team (staff, resident, fellow, NP) should be present during the PACE activation. If they are not, then the most responsible house staff should be paged immediately after your arrival to the bedside.
  • If the PACE team recommends a significant change in the plan of care for the patient based on their clinical status, then the patient’s attending MRP MUST be notified by the PACE MD. Otherwise, communication with the attending MRP can occur through the most responsible resident at the discretion of the PACE team.
  • Any involvement on PACE is considered to be part of your PCCU rotation for evaluation.

If you have other questions about PACE, a complete Roles and Responsibilities Manual is located on the PACE SharePoint Intranet site that can be accessed from Citric using the following instructions:

Once at the Citrix homepage, select HHS intranet and then from the Departments and Committees tab, click on PACE.

A PACE card for your ID badge with the activation criteria has been provided in your orientation package.

Thank you and enjoy your rotation.