STAT - Your Patient Needs Help. Who Should You Call?

The new Rapid Response Team is available 24-7 to help care for patients who are in trouble and to reduce code blues

To the rescue

When you’re not sure what’s wrong with your patient, the Rapid Response Team can help, as seen in this mock scenario. The team: respiratory therapist Kimberley Strucke (left), critical care nurse Sandra Derbyshire, R.N. (center), internist Christopher Cutitta, D.O., and hopsitalist William T. Ford, M.D. (both right), respond when called by Jill Hinnershitz, R.N. (second from left), to help a patient on 7A.

You’re a medical-surgical nurse. You notice your patient’s blood pressure and heart rate is dropping, and he doesn’t look right. You’re not sure what’s wrong. What do you do? In the past you would have called the patient’s attending physician or the resident. Now you can call the Rapid Response Team (RRT), too.

A team of experts—a critical care nurse, respiratory therapist and hospitalist—quickly arrives to help you assess and treat your patient, while you continue communicating with the attending physician.

“Patients can begin to deteriorate before a cardiac or respiratory arrest occurs (the heart stops or breathing stops),” says nursing administrator Molly Sebastian, R.N. In fact, 66 percent of patients show signs and symptoms of cardiac arrest six hours before it occurs. “We hope to reach patients before their symptoms worsen,” Sebastian says. “Our goal is to decrease code blues (cardiac arrests) on medical-surgical units and improve patient care.” In 2004, 245 code blues were called throughout the network.

Before RRT, if a patient’s respiratory status changed, the nurse would try to contact the attending physician, who would consult with the nurse and a respiratory therapist about what to do. Now, in addition to calling the attending physician, the nurse can call the RRT.

“If a patient is in real trouble and needs to be stabilized, we can do it,” says Sandy Derbyshire, R.N., of MICU/SICU, who will rotate shifts with other critical care nurses on the RRT. “We also can get patients to critical care faster, if necessary.”

For many years, respiratory therapists have been on call to help nurses if their patient was having respiratory problems or if they weren’t sure what was wrong. “By adding a critical care nurse and hospitalist to the response team, we’re taking our care to a higher level, bringing more experts to the bedside,” says respiratory therapist Steve Pyne.

Based on hospitals our size, it’s anticipated the RRT will be called twice a day. After each call, the team will discuss the case—what went well and what could have been better.

The RRT is available to medical-surgical and step-down units at LVH–Cedar Crest. Over the next few months, RRT also will be implemented for similar units at LVH–Muhlenberg.

Need the Rapid Response Team? If you are a nurse on a medical-surgical or step-down unit and need the Rapid Response Team, call a paging operator at extension 1199 and have the RRT paged.

You’re in the office when your colleague suddenly collapses. You’re not a clinician, but can you still help?

Yes, thanks to a powerful new lifesaving tool called an automated external defibrillator (AED). This computerized device analyzes the person’s heart rhythm and jolts the heart back to normal if there’s a cardiac arrest. “We now have 14 AEDs for our clinics, professional office buildings, health centers and security colleagues,” says Don Hougendobler, director of safety. “They’re readily accessible in the entranceways of those facilities.”

So, if you see someone in trouble, here’s how to respond:

• Act fast. A person’s chances of survival decreases by 10 percent every minute.
• Call 5-5-5. You (or someone with you) should call LVHHN‘s emergency hotline immediately.
• Use the AED. It’s best if the AED user also knows CPR, says paramedic Joel Calarco of the Emergency Medicine Institute. But if that’s not possible, don’t hesitate. Open the device, turn it on, apply the pads to the victim’s chest and follow the prompts. If you know CPR, apply one shock followed by immediate CPR beginning with 30 chest compressions. Check for a rhythm after two minutes of CPR.

Do you know the new CPR guidelines? If your job requires CPR certification, you can get it free here and learn the new regulations.

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