The Rapid Response Team (RRT) provides a reliable system to rapidly respond to patients exhibiting signs of clinical deterioration. The RRT consists of different response teams that are activated depending on the situation and location of the patient. The Rapid Response Team responds to inpatients and provides expert consultation at the bedside. The STAT Team transports critically ill inpatients to the ICU. Staff are trained to recognize warning signs, communicate using SBAR, and activate the appropriate response team in order to ensure patient safety.

1. EMERGENCY MEDICAL RESPONSE SYSTEM:
USING THE RAPID RESPONSE TEAM (RRT)
• Staff will know when and how to use the Emergency Medical Response
System.
• Staff will have clear expectations and be better able to communicate needs
when calling for a RRT (1-1111)
• Activators will not hesitate to call for assistance through the Emergency
Medical Response System.
• Staff will realize and use effective communication tools in the clinical setting.
GOALS FOR EDUCATION

2. WHAT IS AN EMERGENCY
MEDICAL RESPONSE SYSTEM?
This system represents an intuitively
simple concept:
When a person or patient demonstrates
early warning signs of imminent clinical
deterioration, a team of providers is
alerted to immediately assess and treat
the emergency.
This system is a reliable way for patients
and non-patients (including visitors and
staff) to get emergency help early.

3. WHO am I talking to?
The LifeFlight Communicator is a trained Emergency Medical Technician
who understands medical situations.
WHY do I call?
To provide a reliable safety net for the care of persons or patients who have
the potential for decline or who need help.
HOW do I call?
• Dial 1-1111
• From a cell phone, call: 421-1111 (e.g. If you are in a bathroom,
hallway, or parking garage.) The call back number can be a cell
phone number.
• It is best to call from where you can see the patient, especially if you
are a clinician. Ideally, call from the bedside.
THE WHO; HOW; AND WHY

4. WHAT do they ask me?
1. WHERE is your emergency? (Building, Floor, Room, POD)
2. Is this call regarding an admitted patient or non-patient?
3. Is the person breathing effectively? (The purpose of this question is to
rule out a “code” situation)
4. Caller’s name?
5. Caller’s call back number?
LET’S DON’T FORGET THE “WHAT”

5. The Emergency Medical
Response System
-- improves patient safety by providing a
reliable safety net of care for patients who
could potentially deteriorate.
-- designed to get help rapidly to:
• Patients
• Visitors
• Vanderbilt staff
-- consists of several different teams:
• STAT Team
• Paramedics
• Rapid Response Team (RRT)
-- includes Activators and Responders
who work together to ensure patient safety.
Tiered Response System
One Call Does it All!
• Activators Call
• Responders come to the
location
• Every Patient; Every time
• Don’t hesitate to call

6. HOW IS RESPONSE DETERMINED?

7. WHAT IS THE ACTIVATORS ROLE?
• Stay with the
patient
• Provide
Information and
perspective to
patient/family
• Stay with the person for whom
the call was made and provide
information to the team when
they arrive. You know the most
about the patient.
• If familiar with the location, you
may be asked to grab supplies
for the team (e.g. oxygen tank,
heart monitor, IV equipment) or
direct the team on where they
can find particular supplies
• A clear plan should be outlined
and agreed upon by all team
members (RESPONDERS AND
ACTIVATORS) before the team
leaves.

8. One
Call
Does
It
ALL!!
TIERED RESPONSE SYSTEM

9. Who is this for: Family, Outpatients, Staff, and Visitors.
Who Responds: ED Paramedic and one other Staff from the ED
(PCT /RN/Paramedic).
What to Call for: Medical emergencies, Injuries, Splinting, Inpatient
Falls with possible neck injuries
Where do they respond: Vanderbilt medical campus, within 250
yards from the doors of the Hospital.
What do they bring: Stretcher, Emergency Medications (Cardiac
Drugs, and Allergic Reaction), Monitor, Oxygen.
What to expect: Help to move the patient quickly to the ED.
Paramedics may also document a refusal of care if this occurs.
EMERGENCY RESPONSE SYSTEM:
TIER 1 - ED PARAMEDIC RESPONSE

10. • The Rapid Response Team provides
reliable expertise and addresses acute
concerns to in-patients at the bedside.
• The RRT team is a consult service and
does not assume primary care of the
patient.
• The policy states: The Rapid Response
Team (RRT) may be activated when non-
Intensive Care Unit (ICU) patients meet
any of the Early Warning Signs.
EMERGENCY RESPONSE SYSTEM:
TIER 2 - RAPID RESPONSE TEAM (RRT)

11. You can expect the following once the
RRT responders arrive:
• A Nurse Practitioner, Respiratory
Therapist and ICU RN will arrive. The
team will introduce themselves.
• Describe the situation using SBAR
Example: “56 year old male, post-
operative day 2 from a knee
replacement; Heart rate in the
120s with 10/10 knee pain.
Patient last had pain medication
8 hours ago. I think this patient
needs an adjustment to his pain
regimen”
THE RAPID RESPONSE TEAM IN
ACTION IN THE INPATIENT
SETTING (CONT’D)

12. Once you have activated the RRT,
remember the following:
R RN at bedside to present
SBAR
A Apply Oxygen
P Primary Team Notified
I Information Obtained and
Patent IV’s
D Desktop computer to bedside
THE RAPID RESPONSE TEAM IN
ACTION IN THE INPATIENT
SETTING
SBAR
S Situation
B Background
A Assessment
R Recommendation

13. Patients and families can also activate
the Rapid Response Team
•Patients and Families should be told to
activate the Rapid Response team if they feel
that something is "just not right," or if there is
a medical emergency
•Instruct patients/families to, “Call 1-1111 for
the Rapid Response Team and notify your
nurse that something is wrong.”
•Telling patients about the Family Initiated
Rapid Response Team is important because it
has been proven that it can save lives and is
something staff are expected to do. (Policy CL
30-08.16)
FAMILY INITIATED RAPID RESPONSE ACTIVATION
PATIENTS AND
FAMILIES NEED
SAFETY
INFORMATION TOO
Who else ensures
the safety of those
they serve?
Watch this video:
http://youtu.be/02w
CTmtKz2k

14. The STAT team consists of :
Several ICU physicians
ICU nurse
Respiratory therapist
Administrative Coordinator
•Expectations of the Activator:
Stay with your patient
Know the CODE status of your patient
Given a brief SBAR
Situation
Background
Assessment
Recommendation
Assist CODE team as needed.
•Once the team agrees that the patient is safe to move, the patient will be
transported to the ICU. The bedside nurse will be expected to give a hand-over
report to the ICU nurse
EMERGENCY RESPONSE SYSTEM:
TIER 3 - STAT TEAM

15. • Remember, when the
STAT team arrives:
• Know the code
status
• Give SBAR
• Work with the
team
• Assist with
handover and
disposition
TIERED RESPONSE SYSTEM:
TIER 3 - STAT TEAM (CONT’D)

16. Use the tools discussed on the next slides
to ease facilitate communication among
Healthcare Team providers and staff
COMMUNICATION TOOLS

17. Communicate the following information:
• S Situation:
• What is going on with the patient? What happened to the
patient? What happened to the patient to make you think they
need a rapid response call? What did the patient do? Was
he/she shaking, gasping, confused?
• B Background:
• What is the clinical background or context?
• A Assessment:
• What do you think the problem is?
• R Recommendation:
• What would you recommend?
Use SBAR format to communicate.
SBAR is a framework for team members to effectively
communicate information to one another. Giving specific details will help
the team provide better care.
SBAR

18. Closed Loop communication is used for all
verbal orders (Check Back) and to confirm
plans (Validate the plan and repeat this back
to the team).
Check Back:
Process of employing closed-loop
communication to ensure that information
conveyed by the sender is understood by the
receiver as it was intended.
Check Back Steps:
1. Sender initiates the message.
2. Receiver accepts the message and
provides feedback.
3. Sender double-checks to ensure that the
message was received.
CLOSED LOOP COMMUNICATION
Check Back
Example:
Dr. (Sender): “Give 25
mg Benadryl IV push.”
RN (Receiver): “25
mg Benadryl IV push.”
Dr. (Sender): “That’s
correct.”

19. To help ensure that you’ve clearly communicated your message and
apprehension about the patient’s condition, use these words:
“I am concerned about. . . “
“I am uncomfortable about/because/with. . . “
“I feel this is a safety issue for my patient/staff because. . . “
CUS

20. Emergency Room Team (Adult ED Only)
Who responds? Emergency Dept.
Attending physician
Who is this for? Inpatients boarded in
the ED
When to call? RRT Triggers
Where do they respond? Adult ED
Only
What to expect: Treatment and when
completed, a clear plan of care which will
be communicated with the healthcare
team and the patient and/or family.
ADULT EMERGENCY ROOM RRS
Lifeflight Communicator
The Lifeflight Communicator is
a trained Emergency Medical
Technician who understands
medical situations & is able to
make decisions to speed the
medical response.

21. Visit the Rapid Response website for more
information:
http://www.mc.vanderbilt.edu/root/vumc.php?si
te=resuscitation&doc=14705
Find helpful information such as:
Tiered response
Special response teams
Origin and philosophy of the RRT
Vanderbilt Emergency Response map
Current data related to RRT
RRT policy link
RRT documentation
How to order more badges
Process improvement ideas
MORE INFORMATION AVAILABLE