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... Read More
Mar 12, '11Rapid 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.
Mar 13, '11Quote from Esme12Couldn'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!"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
May 29, '13hi 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?
May 29, '13just 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.
May 29, '13Quote from vincent paulThink 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?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?
May 30, '13If 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.
May 30, '13Quote from vincent paulGood quality CPR should produce a measurable systolic pressure. This can be difficult to read for a NIBP machine or manually due to interference from the CPR itself, but with an A-line in it's usually readable, I've had patients that we've managed to keep a systolic of greater than 80 throughout CPR. A Lucas device (thumper) has been show to be able to keep systolic greater than 100 for sustained periods of CPR.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?
Dec 11, '16Yes this is a good question that I wish all nurses know the answer to I recently had a loved one on the telemetry floor that was very sick at the time and I asked for help on multiple occasions over a six hour period and I was told by the nurse each time that she was OK and three hours later she passed away and I had to let the nurse know that my love had passed away and then she called a code bluebut it was too late
Dec 11, '16This is an example of overthinking.
Some places the RR team is the same as the CB team. Some places the difference between RR an CB is a doctor responds.
A talking patient may need the CB team sometimes and an unresponsive patient may need the RR team sometimes.
Good discussion, but don't lets get carried away.
Know the diff? Call the right team. Don't? Ask, someone you trust and that person will make the call.
No big. We're all professionals here.
Dec 13, '16We have a graded system that seems to work
1. Code sepsis - positive sepsis screen - an ICU nurse goes to the patient. Assesses and if septic can give fluid and get BC. Communicates with provider. If unable to reach provider can call ICU provider for more orders.
2. Code met - unexpected change in patient condition or deterioration from expected - ICU nurse, RT, hospital medicine, and nursing supervisor - either stabilize the patient or nursing supervisor arranges ICU bed
3. Anesthesia alert - patient needs to be intubated but is still awake - RT, Resident, anesthesiologist with drugs for intubation
4. Difficult airway alert - Known or difficult airway (ENT surgery/radiation/previous difficult airway) anesthesia, ent, surgery, airway cart from OR.
5. Code Blue - cardiac or respiratory arrest - anesthesia, ICU nurse, RT, ICU PA/NP, hospital medicine, nurse supervisor
Basically the code is called based on patient condition. We added the anesthesia and airway codes because people would call a code blue when someone needed to intubated. The presumption is that the patient does not require drugs because they are unconscious and getting CPR so anesthesia would show up without drugs.
Dec 16, '16Quote from JroebuckJust a question for clarification: a patient passed on a tele floor, while on the monitor, and no one noticed until you said something?Yes this is a good question that I wish all nurses know the answer to I recently had a loved one on the telemetry floor that was very sick at the time and I asked for help on multiple occasions over a six hour period and I was told by the nurse each time that she was OK and three hours later she passed away and I had to let the nurse know that my love had passed away and then she called a code bluebut it was too late
Jan 8, '17I agree with Esme, don't get hung up on the words, just get help when you need it.
I respond to Rapids and codes and for each you will get an ICU rn, a doc, and an Rt. The only difference is a Crna will come to codes without being called.
One of the Swat rns at my first nursing job made it very simple for us to decide between the two. He said "I have ten minutes to respond to a rapid and three to a code, if you don't think your patient will last ten minutes, call a code."