Rapid Response Teams Recognition of Clinical Instability

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Rapid Response TeamsRecognition of Clinical
Instability
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Measures Of Clinical Instability
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Signs Of Respiratory Distress/Failure

• Respiratory distress Increased work of breathing
• Increased respiratory rate
• Nasal Flaring
• Retractions
• Grunting
• Color Changes
• Diaphoresis
• Wheezing
• Respiratory failure Inadequate
  oxygenation/ventilation
• Decreased Saturations
• Decreased Level of Consciousness
• Decreased Air Movement (hypoventilation or airway
  obstruction)
• Compensatory Cardiovascular changes(increased
  HR, decreased perfusion)
• Increasing PaCO2
• Decreasing PaO2
• Apnea

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Signs of Shock

• Early signs (compensated)
• Increased heart rate from baseline
• Poor systemic perfusion capillary refill gt 2
  sec.
• Possible increased BP
• Late signs (decompensated)
• Weak central pulses
• Altered mental status
• Hypotension
• Note Cascade of increasing symptoms occurs
  (increasing heart rate, decreasing perfusion,
  normal to high BP ) with then decreasing cascade
  prior to arrest ( decreasing BP, decreasing HR,
  respiratory failure, arrest )

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Signs Of Septic Shock

• Cardiac output may be normal, increased, or
  decreased.
• Hypotension and poor end-organ perfusion may be
  present despite good skin perfusion.
  Hypotension is still a sign of decompensation.
• Early signs of sepsis/septic shock include
• ---Fever or hypothermia
• ---Tachycardia and tachypnea
• ---Increased or Decreased WBC,
• or increased bands

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Signs Of Increasing Intra-Cranial Pressure (IICP)
IICP produces different signs and symptoms,
depending on the stage of increased pressure.
Age, developmental level, and functional baseline
are essential to know when assessing a child
suspected or at risk for IICP.

• Early Signs Symptoms
• Irritability
• High pitched cry
• Headache
• Vision changes nystagmus, sunset eyes,
  disconjugate gaze
• Nausea Vomiting
• Changes in speech
• Altered LOC

• Late Signs Symptoms
• Dilated, non reactive pupils (due to pressure on
  the oculomotor nerve
• Decreased pulse rate
• Increased systolic blood pressure
• Changes in respiratory rate and pattern
• Unresponsiveness to verbal or painful stimuli
• Abnormal posturing patterns (flexion, extension,
  flaccidity)

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To Meet The Needs Of Worrisome Patients We Will
Deploy Rapid Response Teams
RAPID RESPONSETEAM
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