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Table 3 Triggers for rapid response team activation

From: Reduction in hospital-wide mortality after implementation of a rapid response team: a long-term cohort study

 

No. (%) of RRT activations

(n= 855)

Position of activator calling RRT

 

   Nurse

728 (85.1)

   Physician

113 (13.2)

   Physical or occupational therapist

7 (0.8)

   Nonmedical staff

7 (0.8)

Reasons cited for activating RRT a

 

   RRT activated for reasons Including prespecified vital-signs criteriab

485 (56.7)

   RRT activated for reasons other than prespecified vital-signs criteriab

370 (43.3)

   Staff worried: clinical judgment that patient does not look right

400 (46.8)

   Change in mental status

368 (43.0)

   Pulse oximetry saturation < 90%

285 (33.3)

   Systolic blood pressure < 90 mm Hg

165 (19.3)

   Heart rate < 40, > 140, or change > 30 beats/minute

144 (16.8)

   Respiratory rate < 8 or > 30 breaths/minute

117 (13.7)

   Seizure-like activity

103 (12.0)

   Unresponsive

65 (7.6)

   Color change of patient

51 (6.0)

   Hypoglycemia

30 (3.5)

   Chest pain

29 (3.4)

   Uncontrolled or excessive bleeding

25 (2.9)

   Fall

19 (2.2)

   Respiratory distress

17 (2.0)

   Cold or pulseless extremity

9 (1.1)

   Lightheaded or dizzy

8 (0.9)

   Focal neurologic deficit

8 (0.9)

   Unable to reach treating physician

4 (0.5)

   Hypothermia

3 (0.4)

   Other (one RRT only)

46 (5.4)

Final diagnosis that immediately led to RRT activation

 

   Seizure

120 (14.0)

   Severe sepsis

102 (11.9)

   Arrhythmia

83 (9.7)

   Pneumonia

66 (7.7)

   Aspiration

43 (5.0)

   Syncope/Presyncope

41 (4.8)

   Hemorrhage

39 (4.6)

   Hypoglycemia

34 (4.0)

   Asthma/COPD exacerbation

31 (3.6)

   CHF exacerbation

30 (3.5)

   Psychiatric

29 (3.4)

   Malignancy

24 (2.8)

   Opiate overdose

21 (2.5)

   Medication-induced hypotension

20 (2.3)

   Cirrhosis

15 (1.8)

   Stroke

14 (1.6)

   Atypical chest pain

12 (1.4)

   Pulmonary embolus

12 (1.4)

   Myocardial infarction

8 (0.9)

   Hypertensive urgency/emergency

7 (0.8)

   ETT, tracheostomy tube, or ventilator dysfunction

7 (0.8)

   Medication-induced mental-status change

7 (0.8)

   Dementia

6 (0.7)

   Other (fewer than five RRTs)

70 (8.2)

   Unknown

14 (1.6)

  1. CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; ETT, endotracheal tube; RRT, rapid response team. aDoes not add to 100% because more than one reason could be cited as rationale for RRT activation. bPrespecified vital-signs criteria: pulse oximetry saturation, < 90%; respiratory rate, < 8 or > 30 breaths/minute; systolic blood pressure, < 90 mm Hg; heart rate, < 40, > 140, or change, > 30 beats/minute.