RAPID RESPONSE TEAM (RRT) MD/PROVIDER NOTE

CRITERIA/RATIONALE FOR CALL
  Respiratory distress or threatened airway
  Acute desaturation - acute change in O2 sat <90%
  Hypotension - acute change in hypotension <90 mmHg
  Hypertension - acute change in hypertension >200 mmHg
  Bradycardia - acute change in HR <40
  Tachycardia - acute change in HR >130
  Stroke-like symptoms - acute onset slurred speech, facial droop, 
  numbness/weakness
  Seizure - new, repeated, or prolonged
  Altered mental status - acute change in level of consciousness
  Chest pain
  Sepsis
  Acute bleeding
  Other - Staff concern
  Other - explain below
                                    
RRT Interventions done:
  ABG results: ABG - NONE FOUND
  CXR: result 
  INTUBATION: done by 
  Oxygen administration: what type and how much? 
  Nebulizer treatment: what type? 
  BiPap: what settings? 
  12 Lead EKG: result 
  Venous Access
  Atropine: dose 
  External Pacer
  Naloxone/Narcan
  Fluid Bolus: what type and how much? 
  Lasix IV: dose 
  Pressor infusion: what type and how much? 
  D50 IV: how much? 
  Amiodarone infusion: what bolus and rate? 

    Comments: 
                                    
SITUATION: 
                                    
BACKGROUND: 
                                    
ASSESSMENT: 
                                    
RESPONSE/FOLLOW UP PLAN: 

This event was discussed with attending physician (NAME). 
The primary team was also notified.