At Platte Valley Medical Center, the Rapid Response Team is different from the Code Blue Team that responds to a patient experiencing a cardiac or respiratory arrest. Code Blue is drawn from a medical model. An example would be a hospital patent “Coding” –no breathing, no pulse. The patent’s skin would become blue or ashen – hence Code Blue. The Rapid Response Team intervenes upstream from a “potential code” situation, relying on bedside nurses who are highly sensitive to signs that a patient’s condition is deteriorating, and empowered to call others into action. The Rapid Response and Code Blue staff includes an experienced critical care charge nurse, a respiratory therapist, House Supervisor, Phlebotomist and physician (critical care or hospitalist). A code team leader will be a physician in attendance on any code team; this individual is responsible for directing the resuscitation effort and is said to “run the code.”
Hospitals using Rapid Response Teams typically observe reductions in the number of cardiac arrests, unplanned transfers to the ICU, and, in some cases, the overall mortality rate.
When a patient demonstrates signs of imminent clinical deterioration or early signs of potential downward spiral, nurses on units outside of the ICU call a “Rapid Response Team,” also known as a RAT. Bedside nurses call by phone or overhead page, and team members are alerted simultaneously or sequentially. During a Code Blue, the bedside nurse pushes the blue button on the wall in the patient’s room or calls #555 so it is announced over the hospital public address system. During a RAT or Code Blue, appropriate staff and doctors would immediately drop what they are doing and respond with the Crash Cart to the coding patent.
RAPID RESPONSE TEAM (RRT)
Criteria for calling the RRT:
- Concern that something is wrong
- Acute change in heart rate (<40 and >130 BPM)
- Acute change in systolic blood pressure (<90 MM HG)
- Acute changes in respiratory rate (<8 OR >24 RPM)
- Acute changes in O2 saturation (<90% despite supplemental oxygen)
- Acute change in mental status
CODE BLUE C
Criteria for calling code blue:
- All Cardiac and Respiratory arrest
- Acute changes in Vital Signs.
- Airway – Threatened
- Breathing – All Respiratory arrests (RR<5, RR>36)
- Circulation – All Cardiac Arrest (Pulse rate<40 or >140)
- Neurological – Sudden fall in level of consciousness or repeated or prolonged seizures
- Other – any patient who may not fit the criteria above who you are seriously worried about