Walston et al identified factors associated with early activation of a rapid response team (RRT) for a patient admitted from the Emergency Department (ED). Early activation of the RRT is associated with ICU admission, an invasive procedure and short-term mortality. The authors are from the Mayo Clinic.

Patient selection: age >= 18 years, admitted from Emergency Department (ED)


Outcome: early activation of RRT (within 12 hours of admission)


Criteria for rapid response team activation:

(1) staff member is worried about the patient

(2) acute and persistent decline in oxygen saturation < 90%

(3) acute and persistent change in heart rate < 40 or > 130 beats per minute

(4) acute and persistent change in systolic blood pressure < 90 mm Hg

(5) acute and persistent change in respiratory rate < 10 or > 28 breaths per minute

(6) acute chest pain suggestive of myocardial ischemia

(7) acute and persistent change in conscious state (altered mental status)

(8) new onset of symptoms suggestive of stroke


Additional reasons for activating the team:

(1) hypertension

(2) seizures

(3) cardiac arrhythmia


Predictors in the ED associated with response team activation:

(1) tachycardia

(2) tachypnea

(3) lower oxygen saturation

(4) extreme value (low or high) for systolic blood pressure

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