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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”.
1
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
2
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