Establish Criteria for Activating the Rapid Response Team

Providing guidelines for calling a Rapid Response Team can be very helpful to some staff. Each organization should determine which criteria will be used to call a Rapid Response Team and educate the staff accordingly. Several organizations use criteria similar to these:

  • Any staff member (nurse, physical therapist, respiratory therapist, physician) is worried about the patient
  • Acute change in heart rate <40 or >130 bpm
  • Acute change in systolic blood pressure <90 mmHg
  • Acute change in respiratory rate <8 or >28 per min
  • Acute change in saturation <90 percent despite O2
  • Acute change in conscious state
  • Acute change in urinary output to <50 ml in 4 hours
 
These criteria are not all inclusive; they are guidelines to assist staff in key recognition opportunities to call the response team when any of these criteria are met. Staff should also be encouraged to call the team whenever they are worried about the patient, whether or not the patient's condition includes any of the criteria.     
 
Methods for activating the Rapid Response Team include the following:
  • Use a beeper, with or without overhead page.
  • Encourage staff to type in/dial in the patient’s room number to the pager.
  • Refrain from the use of multiple steps to activate to the Rapid Response Team. Activation should be easy and reliable 24/7.
  • Many hospitals have encouraged family members to activate the response team, if they recognize a change in the patient's condition.

 

 

Tips

  • Be sure to educate all hospital employees to the criteria. Initially this will involve the wards primarily, but should eventually include areas such as radiology, endoscopy, etc.
  • Family activation of the team should be considered.
  • Be sure to establish a reliable paging system so the team is always accessible.
  • Consider that no call is a bad call — subtle changes can be recognized and early activation of the Rapid Response Team allows additional opportunities for assessment and intervention.

 

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