A Rapid Response Team (RRT) is a specialized group of clinicians dedicated to intervening quickly when a hospital patient shows signs of clinical deterioration outside of an Intensive Care Unit (ICU). This safety mechanism brings critical care expertise to the bedside. The RRT operates on the principle of early intervention, recognizing that most in-hospital cardiac arrests are preceded by subtle physiological changes hours before the crisis occurs. Activating the RRT is a proactive measure intended to stabilize the patient, prevent a catastrophic event, and improve patient outcomes.
Core Mission and Composition
The primary mission of the RRT is to prevent patient deterioration from escalating into a serious medical emergency, such as respiratory failure or cardiac arrest. By identifying and treating instability early, the team aims to reduce the hospital’s “failure to rescue” rate—the failure to recognize and respond appropriately to a patient’s worsening condition. Evidence shows that up to 84% of patients display warning signs of decline six to eight hours before a cardiac arrest event.
The composition of the RRT is multidisciplinary, though members vary between institutions. Typically, the team is led by a Critical Care Nurse, who possesses advanced assessment and intervention skills from the ICU setting. A Respiratory Therapist is also a standard member, bringing specialized expertise in airway management and ventilation. In many hospitals, the team includes a physician, such as a hospitalist or intensivist, or a clinical supervisor, ensuring the authority to make immediate treatment decisions and disposition plans.
Recognizing the Need: Activation Criteria
Activation of the RRT is triggered by specific, measurable clinical criteria. These criteria flag physiological abnormalities that indicate a patient is at high risk of a sudden decline.
Objective Criteria
- A heart rate that drops below 40 or rises above 140 beats per minute.
- A respiratory rate less than eight or greater than 28 breaths per minute.
- A systolic blood pressure falling below 90 mmHg.
- A sudden drop in oxygen saturation below 90% despite supplemental oxygen.
- A significant change in mental status, such as new-onset acute confusion.
Subjective and Family Activation
Beyond objective vital signs, an activation criterion is a subjective “staff concern” or the feeling that the patient “just doesn’t look right.” This empowers bedside nurses to act on their clinical intuition, overriding a reliance solely on numbers. Many hospitals also allow family members to activate the RRT directly if they perceive a sudden change in their loved one’s condition. This family-activated call system acts as a final safety net, ensuring the patient’s needs are recognized by high-acuity personnel.
The RRT Process: From Arrival to Stabilization
Once activated, the RRT mobilizes immediately to the patient’s location, aiming to arrive at the bedside within minutes. The process begins with a rapid assessment using the standard Airway, Breathing, and Circulation (A-B-C) framework to identify immediate life threats. The team determines the cause of deterioration and executes immediate interventions beyond the scope of general floor care. This may include initiating advanced oxygen delivery, administering intravenous fluids for low blood pressure, or giving specialized medications.
The RRT often facilitates rapid diagnostic workup, including ordering point-of-care laboratory tests, such as blood gas analysis, or urgent bedside imaging. This swift action allows the team to make informed treatment adjustments without the delays of a standard consultation process. Following stabilization, the team determines the patient’s disposition. This may involve remaining on the current floor with increased monitoring, or transfer to a higher level of care, such as the ICU, for continued specialized management.
RRT vs. Code Blue
The distinction between a Rapid Response Team activation and a “Code Blue” is fundamental to hospital emergency protocols. The RRT is a proactive intervention, called when a patient is showing signs of decline but is still breathing and has a pulse. The team’s function is to stabilize the patient and prevent the condition from progressing to full cardiopulmonary arrest.
In contrast, a Code Blue is a reactive, last-resort measure initiated when a patient is in cardiopulmonary arrest—meaning they are unresponsive, not breathing, or pulseless. The goal of a Code Blue is immediate resuscitation, requiring advanced life support, chest compressions, and defibrillation. While both teams bring highly trained clinicians to the bedside, the RRT focuses on prevention, whereas the Code Blue team focuses on aggressive resuscitation.