Rapid Response Team

A rapid response team is dispatched to a patient’s bedside to prevent the transfer of a patient to intensive care, cardiac arrest or death. 

The team consists of physicians and nurses who quickly identify conditions in the patients in which the vital signs deteriorating over time while being hospitalized instead of allowing reaching the point of “code blue”. In which a message is announced over a hospital’s public address system, indicating that a cardiac arrest or respiratory arrest requiring CPR (Cardiopulmonary Resuscitation) is in progress.

What is a RRT?

Knowing the “Signs”

Nurses must be aware of signs and symptoms that could lead to cardiopulmonary arrest, or a “code blue.” The condition of a patient before a cardiac arrest can be recognized by staff, and early interventions can be initiated to prevent a “code blue”.

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Any staff member may call the team if one of the following criteria is met:

Heart rate over 140/min or less than 40/min

Respiratory rate over 28/min or less than 8/min

Systolic blood pressure greater than 180 mmHg or less than 90 mmHg

Oxygen saturation less than 90% despite supplementation

Acute change in mental status

Urine output less than 50 cc over 4 hours

Staff member has significant concern about the patient's condition

 

Typical RRT System Calling Criteria

Additional criteria used at some institutions:

Chest pain unrelieved by nitroglycerin

Threatened airway

Seizure

Uncontrolled pain

Typical RRT System Calling Criteria

In the past the failure to identity a failing patient has resulted in the lost of lives.

However, with the implementation of RRT’s in hospitals lives have been saved.

Why were RRT implemented?

Challenges Administrators FaceHow to manage and allocate

resources

Ensure the best possible patient care

Pressure to quickly discharge patients while still providing quality care

Solution has evolved into the creation of RRT’s.

Success of RRT

RRT significantly reduce costs by avoiding unnecessary transfers to the ICU

Reduce cardiopulmonary arrests

Avoid complications that may occur that which would cause longer stays in the hospital.

Patient care involves multiple staffing interactions and caregivers’ knowledge, skills, expertise, technology, supplies, and medications. Patient care is not one single intervention or a series of isolated events.

Success of RRT

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According to data reported in 267 patients, use of RRTs during a 16-month period resulted in a 56% reduction in the monthly rate of code blues in medical-surgical units (Figure 3⇓). In 2006, the mean number of code blues outside the ICU, emergency department, and operating room per 1000 discharges each month was 0.63, a decrease from 1.22 in 2005. Unanticipated transfers from the medical-surgical units to the ICU were decreased by 10%.

 

This study was conducted in a 16 months and so far results have been positive.

Success of RRT

http://psnet.ahrq.gov/primer.aspx?primerID=4

http://ccn.aacnjournals.org/content/27/1/20.full