Rapid Response Team Stories

Nurses Safety

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Specializes in Trauma ICU, Critical Care, Adult Health.

Hi All,

I am looking to hear bout some Rapid Response Team stories from all points if view, both the responders and the bedside nurses. Does anyone have any interesting stories?

Thanks,

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

If you're called to a RR or a Cor, ALWAYS bring a pen and notebook. In my experience, that's the one thing that EVERYONE forgets, to start recording/documenting. So now, whenever there is a Cor, I always grab a pen and notebook.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I am curious...what are you doing research for?

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Specializes in Trauma ICU, Critical Care, Adult Health.

Hi Esme12,

I am teaching classes on RRTs and am looking for some stories. I am a FT educator and left critical care 2 years ago (still do ICU/ER) clinicals.

Thanks!

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Specializes in Med/Surg, Academics.

Very early in my career, I had a non-English speaking patient who was alert and oriented via language line. In the middle of the night, she had to go to the bathroom per the NA who spoke Spanish. I went in to help her because I wanted to assess her mobility, which you don't often get a chance to on 8 hour nights. She spoke to me in Spanish, but I thought she sounded a little off. I called in the NA and said, "Have her say something and tell me if you think her speech is slurred." The NA did as I asked, and she said, "Yeah, a little bit." I called a rapid, and the doc called a stroke code. I gave the last known well time, and the patient ended up tPa'd in the ICU for acute infarct on the CT. Lesson: even if the patient doesn't speak English, know the patient's normal speaking voice during language line assessment so that you can pick up changes.

Patient diagnosed with the flu. First rapid on him for sudden SOB and anxiety near the start of shift. Put on a venti at 35%. Docs hemmed and hawed about transfer to ICU. Called another one a few hours later for increased oxygen demands to maintain saturation. Pt finally transferred to ICU and intubated three hours after transfer. Lesson: even if a patient isn't transferred after the first rapid, that doesn't mean they shouldn't be. Call another one if continued deterioration and push for transfer.

Change of shift and doing hand-off rounds. The patient looked like she was sleeping and a bit groggy during introductions. Mild supraclavicular retractions, so I did a quick count of RR. 32. Listened to lungs, and they sounded like Rice Crispies in all posterior fields. Pt said she was a "little short of breath." Most likely flash pulmonary edema, and considering the docs were doing shift change too, I called a rapid to get her assistance quickly. Good thing because her IV was not patent and she was a hard stick. Took three tries from three experienced ICU nurses to get the Lasix in her. She also went into afib with RVR during the rapid, so diltiazem was started too. Lesson: act quickly BEFORE the patient starts circling the drain and don't let the previous nurse's statement that "she's been like that for a while" deter you. It's your shift and your patient now.

Pt came up from the ER obviously unstable. Diagnosis was COPD exacerbation. He was diaphoretic, anxious, with a high RR, but all other VS ok, even NSR on the monitor, surprisingly. Neb had been given 30 minutes previous in the ER. I called it anyway because I didn't like the way he looked, and I thought he would crash on me. Middle of the rapid, the radiologist called me with high probability of a PE. Told the docs, and off he went to ICU. Lesson: don't be afraid of calling a rapid on a very sick patient straight from the ER. All results may not be back prior to admission, and they can change everything.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Hi Esme12,

I am teaching classes on RRTs and am looking for some stories. I am a FT educator and left critical care 2 years ago (still do ICU/ER) clinicals.

Thanks!

very cool.....I would think critical care ICU scenarios could apply as well from your past to show interventions and progression of intervention...or the lack thereof.
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Specializes in Neuro ICU and Med Surg.

When in doubt call a rapid. If your patient just isn't right to you call.

Yesterday (working New Year's Eve night), I was called to a code that I think may have been prevented if the staff would have called a rapid. The patient had a stroke the previous admit and this time he was admitted for a SBO. His son said he suddenly was not able to swallow, and he "just is not right". I guess the house doc was called, but RRT was never notified. The pt did have an MRI, but no changes. The pt aspirated, and coded. As I was getting this pt settled in the ICU another pt on that floor went into A Fib with RVR. The nurse never called me until she received an order for IV lopressor. They can't give the lopressor IV on that unit so I ended being called for the IV med administration.

Even if you don't think you really need a rapid, call if you are unsure. A nurse did that tonight. I helped get her in the right direction with that patient.

I have had nurses call for DNR patients. We can treat still within code status so if you have an issue or concern please call.

I wish nursing education didn't use call rapid response for everything.

I am sure I could think of more later, but I am tired.

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Specializes in Pediatrics.

Had a pt who was an onc pt in remission on my floor for rehab, got up to go to the bathroom had a near fall with the CNA while walking to the bathroom. She helped him to the floor and called for help.

We got to the room began assessing him and to get him moved to the bed he had just seemed off. He was answering my questions but slower to respond then his respiratory and heart rate shot up.

Called the RR, transferred to the ICU, 3 days later he passed away. His cancer had returned while he was in rehab and has overtaken his systems. Looking back, he hadn't been feeling well for a couple of days, made many of us nurses sick about it as he had been on our unit for over a month and we knew him well.

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Specializes in Trauma ICU, Critical Care, Adult Health.

dudette10, Thanks for sharing your experience. It sounds like there was a lot going on! I have has some similar shifts like that. Excellent job in taking care of this patient and getting her the attention she needed.

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Specializes in Trauma ICU, Critical Care, Adult Health.

nrsang97, Thanks for your story. I totally understand you when you remark it seems as if the rapid response is for everything, but you also mentioned that you helped the nurse get in the right direction with the patient and that is great. A part of that too, is educating all nurses how to use the system. Thanks again, for sharing!

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Specializes in Trauma ICU, Critical Care, Adult Health.

Klone, thanks for the tips! Do you find now that with standardization of the RRTs (such as the RRT nurse bring the RRT form to the call) that starting to document is becoming less forgotten?

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Specializes in Neuro ICU and Med Surg.

We document in the EMR during the rapid response. In paper charting the RRT had the rapid form, but if we didn't have one we were able to print one off the computer.

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