Rapid Response vs Code Blue?

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.

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 pulse less 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-pulse less ACLS algorithms (tachycardia, pulmonary edema, etc) as a RR and pulse less 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.

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.

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.

I completely agree with Esme. If you think there's something wrong, call a RR. That's why they're there.

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.

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.

We have posters around that show criteria for RR - use it and call it.

Code Blue -- patient is dead

Rapid Response -- change in pt condition from respiratory distress/severe hypotension all the way up to "almost dead, just about to die." Don't call a Rapid Response if the patient's not breathing or doesn't have a pulse. We had a nurse call a RRT, because the patient had lost a pulse but was still "breathing" -- the patient was having agonal respirations, O2 sat was in the 40's and dropping, and asystole. Pt should have been a code. I got there, slammed the button, but it cost the patient 3 minutes they didn't have.

When in doubt, hit the big blue button. I'd rather run to a code that was a RRT than hurry to a RRT that should have been a code.

Rapid 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.