Hello everyone, thank you for taking the time to read this and hopefully send feedback. Here's a brief run down of the situation: I work at a 800 bed teaching hospital, not University based, in NC. We have a dedicated, RN led, Rapid Response Team that uses a pre-approved order set/protocol, based on common emergencies. In the beginning, of course it was very basic & the order set/plan had to be presented & approved by our MAC (medical administration committee) before it was put into use. It was revised in 2009, and again had to be presented & approved, which it was. At that time we added an anaphylaxis reaction, sepsis, ACS & NPPV for respiratory distress subplan. We have been using the order set/protocols for the past 9 years without problems. Then, couple years ago, we acquired new critical care management who now feel we have too much autonomy, or so it seems. This director wants the team to have to call the physicians before initiating orders from our order set, such as ABG's w/lactate, NPPV, IV fluid bolus ect...Of course the physicians are paged as soon as possible but sometimes stopping to page instead of treating the emergency can literally mean the difference on whether that patient codes or not. So, my questions are, how does your Rapid Response Teams function? Do they have order sets they can institute prior to paging the physician? What is on them? Basically, tell me how your team functions at your hospital please. Thanks in advance.