Rapid Response Meds

How about IV Lasix, Ativan, and D50? We seemed to use these a lot when I was on a RRT (in addition to the MSO4 & NTG). Of course, you would steer clear of protocoling anything that would be an ACLS or code drug. We just got orders or called a code if we needed a pressor, etc.

The only drug intervention allowed to be initiated independently by our RRT is Narcan 0.4mg IV.

With the being said, the hospital has certain standing orders or protocols for things that allow for nurses to give certain meds. For example, there's a standing order to administer D50 when blood sugar is critically low...it isn't something specific to only rapid responses, but definitely used in a RR if needed.

If the situation progresses to a code, ACLS or code drugs can be used.

Any other drugs are physician ordered.

We don't have standing orders for RRTs as there is always at least one doctor who responds to the call (teaching hospital). But, we do have a form with interventions to check off which is used as quality control. The form includes the meds already listed, in addition to a liter of NS, albuterol neb, I think benadryl, and maybe some others. But the actual orders come from the doctors.

Right now we are in are begining stages of assembling our RRT program where I am. I am one of the RNs who is doing the educating, documentation forms, policy writing etc,. So far for our institutional orders that have been approved as of right now are: Albuterol SVN, Narcan IV and may repeat X1 , Romazicon IV and may repeat X1 , Nitro SL, ASA PO, Morphine IV X 1, atropine IV, and a 250cc IV bolus may repeat X1.