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


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%



heart rate > 120 beats per minute


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


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