Jones et al reported clinical indicators for intensive care unit (ICU) admission following the call to the Rapid Response Team (RRT) to assess an inpatient. These can help to identify a patient who may be deteriorating and who may benefit from more aggressive management. The authors are from Columbia College of Physicians and Surgeons, University of Melbourne and Monash University.
Patient selection: hospital in-patient examined by rapid response team
Clinical Finding
Features
potentially threatened airway
stridor, noisy breathing, bleeding into airway, swelling of airway, other
sustained tachypnea or increased work of breathing
respirations > 26 breaths per minute
central cyanosis and/or oxygen saturation <90% with FIO2 > 40%
tachycardia
heart rate > 120 beats per minute
hypotension
systolic blood pressure < 100 mm Hg
altered skin color suggesting poor perfusion
cool periphery, mottled skin, prolonged capillary refill time
altered level of consciousness or new onset of focal neurological deficit
reduced Glasgow coma score, delirium
protracted or frequent seizures
protracted if > 5 minutes; frequent if > 2 in a 12 hour period
rising serum creatinine concentration
upward trajectory in serum creatinine concentration, even if still within normal range
rising serum lactate concentration
serum lactate concentration > 3 mmol/L
To read more or access our algorithms and calculators, please log in or register.
