Rapid Response VS Code Blue?

  1. 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 floor now as a tech and there have been plenty of Codes and RR but I can't figure out the difference. I understand a code blue is when a patient has difficulty breathing, stops breathing, etc and I've been in situations where patients are unresponsive/pass out and they call rapid response. Also a nurse on the floor just the other day said to me, after a patient had "coded" and was transferred to ICU, "I called a code and it ended up turning into a rapid response". This confused me even more. ??????.

    Is there a difference in the nurses responsibility in either a code blue vs rapid response?

    I'd just like to clarify seeing as I will be taking NCLEX soon and working on the floor shortly after, and when I am presented with different situations I need to know what to call!!!
    Hygiene Queen and lindarn like this.

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  3. 20 Comments...

  4. 3

    I work on a cardiology floor. In a code blue, the patient is unresponsive and does not have a pulse. In a rapid response, there is a change the patient's status, such as difficulty breathing, hypotension, oxygen sats less then 90%.
    Hygiene Queen, Otessa, and lindarn like this.
  5. 1
    Keep in mind - many such questions have answers that are completely site-specific. Where I work, neither term means anything: we have "Codes", and medical and paychiatric emergencies. Such terms refer to a very specific response elicited whenever each one is called, as determined by your institution. You need to learn the lingo where you work, and learn to use the appropriate term to get the help you need in any given situation. Forget the NCLEX, except in terms of learning how to make those clinical judgements.
    lindarn likes this.
  6. 5
    I think you'll find the definitions for a rapid response, and when a RR becomes a code, varies by facility.

    In general, A RR is for a significant change in patient condition, and used to hopefully avoid a code. The policy at my facility still defines a Code as being for any unstable patient and/or when ACLS is indicated. Although in practice you pretty much have to be pulseless to get coded, mainly because if the code teams arrives and the patient is still conscious or breathing at all they will turn around and leave, even if the patient is in a sustained Ventricular rhythm and symptomatic.

    As a result, we do non-pulseless ACLS algorithms (tachycardia, pulmonary edema, etc) as a RR and pulseless algorithms as a code.

    What earns a RR also varies some by floor, ie: Medical and surgical floors call a RR for chest pain, the tele floor does not. The observation unit calls a RR for O2 sats <90, others put a cannula on the patient.
  7. 3
    A code blue is an unresponsive pt with no pulse

    A rapid response or at my hospital a code yellow is when there is a rapid decline in the pts condition and you need help fast.

    My hospital does not punish the nurse / pt for calling a wrong code. If you call a code blue but it is really a yellow the team will still stay and stabilize the pt. In a debriefing a supervisor would just explain the difference But calling the wrong code is better than calling no code so our code team is taught to be really supportive to the floor nurse.
    hannah1979, hiddencatRN, and lindarn like this.
  8. 16
    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
    hannah1979, brownbook, Do-over, and 13 others like this.
  9. 2
    Code blues are called when someone is pulseless or not breathing. We have code blue buttons in all of the rooms so if it looks like a code is immanent (ie pulse & bp rapidly dropping, unresponsive and foaming at the mouth...) The people that show up in the hospital I work at are pretty much the same.

    What a rapid response gets called for really depends on the floor. Different levels of care are able to handle different situations.
    BluegrassRN and lindarn like this.
  10. 3
    I completely agree with Esme. If you think there's something wrong, call a RR. That's why they're there.
    nrsang97, Esme12, and lindarn like this.
  11. 1
    Would like to add that rapid response can apply to sudden acute change to mental status...

    In my facility, RR has a set of guidelines that are specific. For example, new onset of systolic bp less than 90 earns the patient an RR. Symptomatic hypoglycemia past a certain point (sorry can't remember what it is...work in ER) earns you an RR.

    Passing out during PT? Also an RR.

    Found unresponsive...Code.
    Esme12 likes this.
  12. 0
    In the facility I work in the main difference is that for a RR 1/2 of the CAT ( our code blue is called cardiac action team) shows up. Im thinking its IV, nursing supervisor, Respiratory and an ICU nurse. It is used when a patient just has deviated a lot from their base line. Could be resp issues, low or very high blood pressure, fainting, basically just heading south quickly. We can call an RRT on someone who is a DNR.

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