Rapid Response VS Code Blue? - page 2

Okay so I'm sure this is a silly question but it is really bugging me. But as they say "there is no such thing as a stupid question". I hope. What is the difference between a Rapid Response and a Code Blue? I work on a tele... Read More

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    We have posters around that show criteria for RR - use it and call it.

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    Code Blue -- patient is dead

    Rapid Response -- change in pt condition from respiratory distress/severe hypotension all the way up to "almost dead, just about to die." Don't call a Rapid Response if the patient's not breathing or doesn't have a pulse. We had a nurse call a RRT, because the patient had lost a pulse but was still "breathing" -- the patient was having agonal respirations, O2 sat was in the 40's and dropping, and asystole. Pt should have been a code. I got there, slammed the button, but it cost the patient 3 minutes they didn't have.

    When in doubt, hit the big blue button. I'd rather run to a code that was a RRT than hurry to a RRT that should have been a code.
    on eagles wings likes this.
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    so if i go into my pt's room to do my assessment. i notice she is cyanotic, is dyspneic and has a pulse ox of 73%, is that when I would call a rapid response?

    if i go into my pt's room and call the pt by name...she's not responsive. i call her again by name, no answer. i do my ABC check, still nothing. no spontaneous breathing or pulses. this is when I would call a code blue right?
    mitral likes this.
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    Rapid response is "Oh crap, they don't look good".

    Code blue is "Oh *&#% get the crash cart".

    At my facility the goal of a RR is to avoid a full blown code. Basically if there is a change in condition to the point that if there is not rapid intervention the pt will potentially die or suffer serious harm, we call a RR.

    So it kinda depends on the nurse and the floor as to whether or not a RR gets called.

    Like in the post above...some would go ahead and call a RR for the first scenario presented...some would slap on increased O2, call RT to come check the pt, assess for any changes in LS, and call MD for further orders (assuming that there was improvement in sats).

    It's kinda fuzzy...depends on the pt, the experience level of the nurse, response to interventions, etc.

    Bottom line though is it's always better to call a RR, or even a code, and not need all the extra help than to wish you would have hit that button a few minutes earlier.
    pseudomonas, brownbook, SNB1014, and 2 others like this.
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    Quote from Esme12
    Honey, Don't get hung up on the words......It doesn't matter what you call it....but if you need help call for it!
    If someone in the kitchen calls a code because someone passes out ......I would rather run and have nothing to do than not run and have a dead body!

    There will always be someone in the crowd who knows it ALL and will roll their eyes and say...."I have NO idea why she called a code/RR......it's OBVIOUS there's nothing wrong. IGNORE THEM! if you need help call for it.......It's a whole lot easier to back down than say "I wish I would have....." Some people just can't help themselves and have to say SOMETHING about EVERYTHING!

    Some facilities have specific criteria for calling a code or Rapid Response,find your facilities amd get to know it....but never hesitate calling because you are trying to debate what to call......just call. Time will pass and your will get more experienced and before you know it it will be second nature! :redpinkhe
    Couldn't have said it better! Just call, and if anyone gets up your skirt about the level of the call, shrug and say, "But thanks for all the help. Couldn't have done it without you!"
    nrsang97 and mitral like this.
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    hi everyone ! this question bothers me, " If the patient is pulseless (for almost 4 minutes) Code blue is activated and CPR performed; Can i possibly measure the arterial blood pressure by palpation? or NO BP that can be measured?
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    Code Blue is dead patient

    Rapid Response is patient who might be dead soon
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    just to make things sliiiightly more confusing (LOL):
    at my facility, when we call a rapid response, we do not get a physician hence someone to intubate. it is correct to call the RR because you look at this pt is who rapidly decompensating and you think "oh hell nawww, he wont be able to keep up breathing like this for long!!" but, he is still breathing and "technically" ok (re: not in resp arrest).
    so, what often happens is at my place, a RR will be called, the team gets there and the patient looks like respiratory garbage. they call a code blue to get someone in there to intubate. the patient is not dead, but intubating is the best choice for them right now.

    i have heard RR for opiate over doses, pt is breathing (barely) but unresponsive. all they need it narcan, usually and closer observation. additionally, i had a little old sick lady who was baseline mildly hypotensive at change of shift but by med pass she was 75/35. i paged 2 different doctors to get orders. 10-15mins later i still have no response. im thinking "ohhh man, she isnt DNR so this is gonna get messy!" i called a RR, they came in less than 2mins, started hanging fluid boluses and transferred her to ICU in less than 7 mins with the intensivist ready to take the lead. the dr called back after the pt went to ICU. i explained that i had called (and ohhh you betcha i documented it in the computer!) but i was scared the pt was going downhill too quickly.

    also at my facility, when a pt is admitted, we explain RR to families. families are allowed to call a rapid on their loved one. we would hope that the nurse sees something first, but you never know. we would hope they would also let the nurse know something is wrong first, cuz its pretty awkward to hear a RR/code paged to your room overhead and you have no clue.

    lastly, we are making a big push to ensure RR are called BEFORE a code. it is saying that the nurses are "vigilantly" monitoring the pt for a change of status. also, as most people know, even the best run codes do not always end "satisfactorily" so it is usally a better outcome when we catch a decline (aka weird new rhythm) vs asystole.

    also, important to note, from what i have heard and seen a few times, it is unusual for a patient to immediately and suddenly go into asystole. there is usually a rhythm change, first a slight one and then a major one (v tach, v fibb) before a patient has no electrical activity in their heart.
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    Quote from vincent paul
    hi everyone ! this question bothers me, " If the patient is pulseless (for almost 4 minutes) Code blue is activated and CPR performed; Can i possibly measure the arterial blood pressure by palpation? or NO BP that can be measured?
    Think of it this way... If CPR is in progress what kind of a blood pressure do you think this generates in the body? In addition, how useful would this measurement be to you?
    Horseshoe likes this.
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    If your patient is still responding but is deteriorating call a rapid response (thank God for them because back in the day you had no option except to call the doctor which was generally someone on call who had no clue about the patient). If the patient is unresponsive and you can't find a pulse call a code. ICU head nurse says it is easier to downgrade from a code to a rapid response than it is to ungrade to a code. If you think you need help get it one way or the other.

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