A rapid response team (RRT) is dispatched to a patient's bedside when their condition begins deteriorating to prevent cardiac arrest or transfer to the intensive care unit. The RRT consists of physicians and nurses who identify at-risk patients based on changing vital signs. Any staff member can activate the RRT if certain criteria are met, such as abnormal heart rate, respiratory rate, blood pressure, or oxygen levels. The implementation of RRTs in hospitals has been shown to reduce code blue events and unnecessary ICU transfers, thereby saving lives and reducing costs compared to allowing patients to deteriorate to a "code blue" state.

1. Rapid Response
Team

2. 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?

3. 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”.

4. 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
1
Typical RRT System
Calling Criteria

5. Additional criteria used at some
institutions:
 Chest pain unrelieved by nitroglycerin
 Threatened airway
 Seizure
 Uncontrolled pain
Typical RRT System
Calling Criteria

6. 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?

7. Challenges
Administrators Face
 How 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.

8. 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.

9. 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

10. 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.
2
Success of RRT

11. http://psnet.ahrq.gov/primer.aspx?primerID=
4
http://ccn.aacnjournals.org/content/27/1/20.f
ull