A Rapid Response Team (RRT) is a specialized, multidisciplinary group of healthcare professionals who swiftly mobilize to the bedside of a patient in a non-critical care setting, such as a general medical floor, who is showing early signs of clinical decline. The RRT’s purpose is to immediately assess and stabilize the patient’s condition, preventing a severe medical event like respiratory or cardiac arrest. Unlike a “Code Blue,” which is called after a patient has already arrested, the RRT functions as a preventative measure, bringing intensive care-level expertise to the patient before a full-blown emergency occurs.
Why Rapid Response Teams Were Created
The concept of the RRT emerged from the recognition that hospitalized patients often exhibit noticeable warning signs in the hours leading up to a serious event like a cardiac arrest. Historically, patients on general wards whose condition worsened did not always receive a prompt and effective response from staff less experienced in managing acute deterioration. This delay was commonly referred to as “failure to rescue,” meaning the inability of the system to save a patient whose condition was deteriorating.
Institutions began adopting RRTs as a structured way to address this systemic gap and reduce preventable in-hospital deaths. The Institute for Healthcare Improvement’s “100,000 Lives Campaign,” launched in 2004, advocated for the widespread implementation of RRTs as a standard patient safety measure. By intervening during the window of opportunity when a patient first shows subtle changes, the RRT aims to reverse the decline and avoid the need for a full resuscitation effort.
Recognizing When a Response is Needed
The activation of a Rapid Response Team is triggered by specific, objective changes in a patient’s physiological status, which are codified into a hospital’s protocol. These criteria are designed to identify patients whose condition is worsening before it becomes an irreversible emergency.
Common triggers include:
- A respiratory rate that falls below 8 or climbs above 28 breaths per minute.
- A heart rate below 40 or above 140 beats per minute.
- A systolic blood pressure that drops below 90 mmHg.
- A drop in oxygen saturation below 90%, even with supplemental oxygen.
- Acute changes in a patient’s level of consciousness, such as sudden confusion or difficulty waking up.
Beyond these specific vital sign abnormalities, many hospitals permit an RRT call based on a clinician’s “significant concern” about a patient’s overall well-being, even if the measured numbers do not meet a threshold. This subjective criterion acknowledges the value of the bedside nurse’s clinical judgment. Many modern hospital systems also allow patients and their family members to directly activate the RRT if they feel the patient’s condition is not being adequately addressed.
Composition of the Response Team and Immediate Actions
The composition of the RRT is multidisciplinary, ensuring that a range of advanced skills is immediately available at the bedside. A typical team includes an intensive care unit (ICU) nurse, who possesses advanced training in managing unstable patients, and often a respiratory therapist specializing in airway management and breathing support. Depending on the hospital structure, the team may also include a physician, such as a hospitalist or intensivist, or a physician assistant to provide immediate medical direction.
Upon arrival, the team’s first action is a rapid, focused assessment of the patient’s airway, breathing, and circulation. They quickly gather information from the primary nurse using standardized communication tools. Immediate interventions can include securing the patient’s airway, administering supplementary oxygen, and establishing intravenous access for fluids or emergency medications.
The team has the authority to order immediate diagnostic tests, such as blood work or a portable chest X-ray, to quickly pinpoint the cause of the deterioration. They also initiate stabilization treatments, which might involve adjusting ventilator settings, prescribing medications, or addressing an acute infection. This rapid intervention ensures the patient receives critical care-level support without the delay of a transfer.
The Goal of the Intervention and Next Steps in Care
The primary goal of the RRT intervention is to stabilize the patient, reverse the acute deterioration, and prevent a cardiac or respiratory arrest. The team’s actions focus on ensuring the patient’s physiological status returns to a safer baseline. Following stabilization, the RRT determines the patient’s next appropriate level of care, a process known as disposition.
One possible outcome is that the patient remains on the current floor with enhanced monitoring and a revised treatment plan. Alternatively, if the patient requires continuous, specialized observation or advanced life support, the RRT facilitates a safe transfer to a higher level of care, such as the ICU or a Step-Down Unit. The RRT also ensures clear communication with the primary care team and family regarding the change in status and the updated plan, sometimes initiating discussions about goals of care.