Organization of the Rapid Response System

Abstract

The patient admitted to the hospital is already an individual who is at risk because of an underlying pathology that requires inpatient care. When patients decline, they have evidence of clinical deterioration (hypoxia, hypotension, tachypnoea, tachycardia, altered level of consciousness) that is often documented in the medical record 8 to 48 hours prior to a crisis being detected. Furthermore, even if symptoms of critical illness are discovered, they maybe undertreated [2, 3]. This gap between needs and resources can lead to death. The best hospitals are able to find and treat sudden-onset critically ill patients (often with transfer to the intensive care unit — ICU) before harm occurs [1]. In essence, these sudden-onset critically ill patients have an immediate increased need of the resources available for their care. The failure to resolve the mismatch between patient needs and available resources is the cause of the medical emergency [4]. This chapter discusses the system for detecting patients with sudden critical care needs outside the intensive care unit (ICU), and then reliably and efficiently provide them with the resources their lives depend upon.