Failure To Call A Rapid Response

When does failure to call a rapid response create liability? A rapid response team (RRT) is a team of health care providers that responds to hospitalized patients with early signs of clinical deterioration on non-intensive care units to prevent respiratory or cardiac arrest.

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The concept was first introduced in 2005 by the Institute for Healthcare Improvement's "100,000 Lives Campaign." Today, 10 years later, the implementation has been widespread and RRTs have been found to be responsible for improving patient outcomes throughout the hospital by:

• Reducing non-critical care cardiopulmonary arrests,
• Reducing patient deaths from cardiopulmonary arrests, and
• Reducing non-essential transfers to critical care.

Patients whose condition deteriorates acutely while hospitalized often exhibit warning signs. In fact, research shows that cardiac arrests in hospitals are usually preceded by observable signs of deterioration, often six to eight hours before the arrest occurs. When a patient meets one of the criteria, or the nurse or family member feels concerned about the patient’s worsening condition, a team consisting of ICU physician(s), nurse(s), and/or respiratory therapist(s) responds to the patient at the bedside. The team is responsible for stabilizing the patient’s condition and integrating his/her care with the primary team. Appropriate criteria for notifying the RRT may be one or more of the following:

• Acute change in level of consciousness
• Acute change in HR < 40 or > 140
• Acute change in systolic BP < 90 or  > 180 mmHg, change in diastolic BP > 100
• Acute change in RR < 8 or > 28
• Acute change in oxygen saturation less than 90% despite additional oxygen therapy
• Urine output < 50 ml over 4 hours
• Chest pain unrelieved by nitroglycerine or new onset of chest pain
• Symptoms of a stroke (such as loss of change in speech)
• Threatened airway
• Seizure
• Unrelieved pain

Failure to recognize when a patient's condition is deteriorating can lead to failure to rescue and become a key contributor to in-hospital mortality. 

Aguirre Legal Nurse Consulting can assist you in identifying adherences to and deviations from the applicable standards of care. We help assess injuries and identify causation issues and contributing factors. Let one of our legal nurse consultants help you develop your next medical-related case. Call (443) 598-2562 or email us at AguirreLegalNurseConsulting@gmail.com.

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