Nursebob’s MICU/CCU Survival Guide

Critical Care Concepts

Rapid Response Team or Medical Emergency Team

1/15/2006

1. Nurses must be empowered to call a critical care team when a patient shows signs of clinical deterioration.

A. Staff member concerned/worried about the patient

B. Acute change in heart rate (less than 40 or greater than 130 beats per minute)

C. Acute change in systolic blood pressure (less than 90 mm/Hg)

D. Acute change in respiratory rate (less than 8 or greater than 24 breaths per minute) or threatened airway

E. Acute change in blood oxygen saturation (SpO2 less than 90 percent despite oxygen)

F. Fractional inspired oxygen (FiO2) of 50 percent or greater

G. Acute change in mental status (delirium, confusion, etc.)

H. Acute significant bleeding

I. New, repeated, or prolonged seizures

J. Failure to respond to treatment for an acute problem/symptom

2. Defining the Rapid Response Team or Medical Emergency Team (MET)

A. A team of clinicians who bring critical care expertise to the patient bedside (or wherever it is needed).

a. All team members must have flexable duties that all availability when needed.

b. Team Leader - A critical care physician

c. A Critical Care nurse.

d. A Respiratory Therapist.

B. Requirements of the team.

a. Small in size.

b. Experienced at assessing patients’ symptoms.

c. Generally bases on assessment can predict the trajectory of the patients health.

d. Available to any provider who wants a second opinion about a patient.

- Particularly a patient showing signs of potential decline.

3. Intervention is a key component of the team

A. The team is empowered to take action, within their scope of practice.

B. Assists the staff member in assessing the patient’s condition.

C. Stabilize a patient.

D. Reporting to and consulting with the hospital's ICU physician as needed.

E. The patient's attending physician is notified of the team's assessment.

a. Information obtained by the MET is organized to be communicated to the patient’s physician

b. The patient’s physician may order additional tests at their discretion.

E. Patients are transferred to the ICU when appropriate or to an intermediate care unit if their needs do not warrant critical care.

F. The Rapid Response Team member also takes on the role of educator and support to the staff.