Ringing the Alarm: Rapid Response or Code Blue
Sometimes making the split decision to call a rapid response or a code blue for patients in distress can be difficult. Understanding the criteria for each helps nurses differentiate between which alarm to initiate.
To help you better understand the differences between calling a rapid response or a code blue, let’s review the criteria for each.
Rapid Response
Goal: The goal of a rapid response is to intervene before the onset of injury, respiratory arrest, or cardiac arrest.
Initiated by: A rapid response can be initiated by anyone, including family, hospital staff, nursing staff, physicians, and visitors.
Examples of when to call a rapid response
- Heart rate over 140/min or less than 40/min
- Respiratory rate over 28/min or less than 8/min
- Systolic blood pressure greater than 180 mmHg or less than 90 mmHg
- Oxygen saturation less than 90% despite O2 supplementation, deep breathing and coughing efforts, etc.
- Acute change in mental status
- Urine output less than 50 cc over 4 hours
- Staff, family, or visitor has significant concern about the patient’s condition
The members of a rapid response team may include:
- Critical Care Nurse
- Respiratory Therapist
- Primary RN
- Critical Care Physician
- Nursing Supervisor
Rapid response process
- Detection
- Activation
- Response, Assessment, Intervention and Stabilization
- Disposition
- Evaluation
Code Blue
Goal: The goal of a code blue is to perform resuscitation efforts after a person has stopped breathing, or after a person’s heart has stopped beating.
Initiated by: A code blue should be initiated by anyone with CPR certification or someone that can verify if a person has stopped breathing, or has no pulse.
Examples of when to call a code blue:
- Person has stopped breathing
- Person has no pulse
- Unable to determine if the person has a pulse or if they are breathing, and is unresponsive
- Unsure of what to do, and are very concerned for the life of the person
The members of a code blue team may include:
- Code Team Leader
- Critical Care RN
- Respiratory Therapist
- Primary RN
- Critical Care Physician
- Critical Care Resident
- Recorder
- Patient Care Tech or Nursing Assistant
- Runner
- Security
- Nursing Supervisor
Code blue process
- Detection
- Activation
- Response, Assessment, Intervention and Stabilization
- Disposition
- Evaluation
As you can see, a rapid response and a code blue are similar in that they alert a team of highly trained clinicians to respond to a medical emergency. The clear difference is that a rapid response is for the prevention of serious injury, cardiac arrest, and respiratory arrest, and a code blue is called for a person who has stopped breathing, or who does not have a heart beat, with the goal of resuscitation.
Now that you know the clear difference between calling a rapid response and a code blue, we are confident that you will do what’s best for your patients in distress.
