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implementation.6 It should be emphasized that the role of the rapid-response team is to provide a quick second opinion rather than to take over the care of the patient.47 From the outset, the team should have adequate resources, in terms of both personnel and equipment, to manage any critical care event. The system’s afferent limb requires sustained education of hospital-ward staff. Without this effort, the system is likely to fail. Accordingly, repeated and multimodal education of existing and new hospital-ward staff is crucial. Appointment of a physician as team leader may be important because the physician can help expedite transfers to the ICU and can facilitate planning of end-of-life care.12 Successful rapid-response systems consistently deliver a high response “dose” (>25 calls per 1000 admissions). Mature academic systems have at least MEDICAL EMERGENCY TEAM “MET CALL WARD ___” if you are worried about any patient OR if you notice any acute changes in AIRWAY • Obstructed airway • Noisy breathing or stridor • Problem with a tracheostomy tube BREATHING • Any difficulty breathing • Breathing <8 breaths a minute • Breathing >25 breaths a minute • Oxygen saturation ≤90%, despite high-flow oxygen IF PATIENT IS NOT BREATHING, CALL A CODE BLUE CIRCULATION • Pulse <40 beats a minute • Pulse >120 beats a minute • Low blood pressure (systolic). Purpose To provide early intervention to patients outside of the ICU to help prevent an adverse outcome. Policy Statement The Rapid Response Team is a group of specially trained clinicians capable of providing critical care expertise to patients. Team members include a Critical Care nurse, respiratory therapist, nurse practitioner/clinical associate/intensivist. When called to respond, the Rapid Response Team is authorized to provide any appropriate patient care. Rapid Response Teams respond to provide care for adults (16 years or older) inpatients on units identified below (see Applicability). NOTE: For medical emergency assistance for individuals who are not inpatients, refer to Edmonton Acute Policy #II-90, Medical Emergency Response Procedure. If the individuals is pulseless, not breathing, or has aganol breathing, call a Code Blue. Do not call the Rapid Response Team. Applicability This policy and procedure applies to the following units at the Grey Nuns and Misericordia sites. Because of operational differences between the Grey Nuns Community Hospital and the Misericordia Community Hospital, program areas to which the Rapid Response Team will respond varies as outlined below. • At the Grey Nuns, the Rapid Response Team responds to all units excluding the Level 2 Operating Room/PARR and ICN. • At the Misericordia, the Rapid Response Team responds to the following areas: • Medicine • Orthopedics • General Surgery • Geriatrics • Alternative Level of Care • Medical Day ward • Obstetrics • Psychiatry • Emergency Department - inpatients • Diagnostic Imaging - inpatients Responsibility The Rapid Response Team, under the auspices of the responsible Intensive Care physician, will assess, stabilize and initiate treatment. Refer to Appendix for detailed staff responsibilities and accountabilities. Principles The principle of the Rapid Response Team is the provision of optimal patient care. Accordingly, any member of the health care team may activate the Rapid Response Team without risk of negative consequences. All applicable ICU policies apply to the Rapid Response Team. Rapid Response Team Activation Date Effective October 1, 2014 Policy No. II-7 Page 2 of 10 The Rapid Response Team is not intended to be a substitute for the appropriate provision of usual patient care. Procedure Indications for Rapid Response Team activation: • Acute change in heart rate to less than 40 or greater than 140 per minute • Acute change in systolic blood pressure to less than 90 mmHg • Acute change in respiratory rate to less than 8 or greater than 36 breaths per minute • Acute change in oxygen saturation to less than 90% despite oxygen at 10 lpm • Upper airway compromise – audible stridor • Acute deterioration in patient level of consciousness • Staff member is worried about the patient (eg. unexpected change in status) 1. Nursing staff member or respiratory therapist identifies a Rapid