Trigger System

Our rapid resuscitation protocol are called Triggers. Triggers are initiated for patients with unstable vital signs or marked nursing concern. Team 1 and Team 2 attendings will alternate seeing trigger patients throughout the shift. Trigger patients are expected to be seen by attending physician immediately on arrival. EM2 and EM3 will also be responsible for immediate assessment of trigger patients with the attending.

There are 3 levels of response

  • Triggers
  • Rapid Assessment
  • Priority Assessment

The response and mechanisms for activation varies for each level. Please see information on Important Information link on the Dashboard.

Rapid Assessment are those patients who do not meet vital sign trigger criteria, and are not a Trauma activation, STEMI or stroke. For these patients, the attending and EM3 resident are to respond. The trigger resident DOES NOT HAVE TO RESPOND. The EM3 and attending can choose the appropriate junior resident to sign up for the patient.

1) Triggers are going to be still called OVERHEAD and via pagers

2) Rapid Assessments are going to be paged through the dashboard and are going to be called overhead.

3) Priority Assessment are not called overhead. These patients are brought back rapidly and then moved to the top of the e-Rack.

IT IS ABSOLUTELY VITAL THAT THE ROLE DASHBOARD STAYS UP TO DATE. THIS IS TRUE FOR BOTH ATTENDINGS AND RESIDENTS!! It is the responsibility of the attending to make sure that when they start their shift, if they are Team 1 or Team 2, to make sure the role dashboard reflects the change in shift by indicating the new attending.

The residents must designate a Trigger Resident (the EM2 on Team 1) and a Rapid Assessment Resident (the EM3/senior resident on). It is the responsibility of the Trigger Resident and the Senior Resident to make sure that these roles are up to date.

Any systems or processes issues that arises should be flagged as "Process Improvement Flag". Any technical issues can be flagged as "Dashboard Feedback".

This is the page list according to the type of trigger: