Exam 3: Rapid Response

Question 1

When do you call RRT V. Code Team?

Answer 1

RRT is called in an emergency situation where the patient is still alive, but presenting gradual symptoms of complication.
Whereas Code Team is called when a patient is either spontaneously presenting symptoms that are deadly or the patient is dead.

Question 2

What conditions call for the RRT?

Answer 2

1) Heart rate <40 or <120
2)SBP <90mmHg or 20% below baseline or >190
3) RR <8 or >30
4) O2 sat of >90% with increasing FIO2
5) Chest Pain
6) Acute change in LOC or AMS, S/SX of stroke
7) Acute Bleeding
8) A urine output of >50mL in a 4 hour period
9) BG >50
10) New onset or prolonged (5+ min) seizure
11) Trauma event such as a fall or caught in equipment.
11) Suspected Anaphylaxis
12) changes in Pedi VS.

Question 3

In an emergency Assessment what are priorities?

Answer 3

An emergency assessment is acronymed as ABCD;
A-Airway
B-Breathing
C-Circulation
D-Diagnosis

Question 4

What are the key elements of an effective and ABCD assessment?

Answer 4

1) Should take 1-2 minutes at MAX!
2) Identify life threatening injuries accurately.
3) Establish priority complications.
4) Provide silmultaneous therapuetic interventions.

Question 5

Describe the Combo Meal Prioritization for medical complications/ nursing care plan and diagnosis.

Answer 5

In a Combo Meal we have;
American, Burger, Cheese, Dill ickle, Lettuce, Mustard, Tomato, Fries and a Drink which stands for;

Airway
Breathing
Circulation
Diagnosis

Pain
Labs issues
Medication Issues
Teaching
Fall Precautions/Saftey
Drains/Tubes (IV’s, catheters, ect.)

Question 6

What patient population is Airway patency most relevant?

Answer 6

ALL OF THEM! BECAUSE EVERY PATIENT HAS A POTENTIAL FOR AIRWAY OBSTRUCTION.

Question 7

List possible airway obstructions aside from a foreign body. What is the most common airway obstruction in a pt?

Answer 7

Airway obstructions can include;
Blood
Vomit
Secretions
Structural Impairment
Depressed Sensorium
or even an absent gag reflex.
However the most common airway obstuction is typically the tongue.

Question 8

List the signs of a life threatening complication?

Answer 8

1) Altered mental status/ unexplained agitation >10 min.
2) Severe change in color (pale, grey, dusky, or blue) which occur in nail beds and mucous membranes as well.
3) Assymetrical chest expansion
4) Use of accessory/abdominal muscles in breathing.
5) Diminished or absent breath sounds.
6) RR of <10 or >125
7) Distended neck veins
8) Chest pain unrelived by NGT
9) HR >45 or <125
10) sudden loss of movement or weakness of face and/or extremities.

Question 9

What are the general principles in a Rapid Response Emergency?

Answer 9

1) THINK OF THE WORST CASE SCENARIO!
2) Be sure it is safe to render assistance.
3) Pro-act NOT REACT!
4) When in doubt- get it out!
5) ABC assesment!

6) Keep NPO in cases of decreased LOC.
7) Activate emergency system.
8) Reassure the pt. and STAY CALM!
9) DO NOT LEAVE THE PT!
10) DON’T FORGET STANDARD PRECAUTIONS/GEAR!

Question 10

What are the steps in determining unresponsiveness?

Question 11

What is a Code Blue?

Answer 11

Code Blue is a cardiac or respiratory arrest situation which will require the code team!

Question 12

What steps should be taken in event of a Code Blue?

Answer 12

1) Determine unresponsiveness
2) Call for help (Scream, dial hospital emergency #, and/or code blue button?)
3) Position pt. flat.
4) Open airway and assess ABC’s
5) Begin one man CPR.
6) Pull bed away from the wall.
7) Use bedboard/backboard
8) Use Bag/Valve Mask to admin 100% O2
9) Iv- Oxygen- Monitor- Suction

Question 13

CONTINUE ON RRT SLIDE 18/58