What interventions should be taken in a rapid response situation?

Rapid Response Interventions in Emergency Situations

In a rapid response situation, immediately assess responsiveness and breathing, and if the patient is unresponsive with no normal breathing or only gasping, activate the emergency response system and begin high-quality chest compressions at a rate of at least 100/minute and depth of at least 2 inches (5 cm) in adults. 1, 2

Initial Assessment and Actions

Recognition of Emergency

1. Check responsiveness by tapping the victim and shouting "Are you all right?" 1
2. Simultaneously check for breathing (absence of breathing or only gasping) 1
3. For healthcare providers: Check pulse for no more than 10 seconds 1
   • If no pulse or uncertain, begin chest compressions immediately
   • If pulse present but inadequate breathing, provide rescue breaths (1 breath every 3-5 seconds) 1

Activation of Emergency Response System

• For lone rescuers with adult victims: Activate emergency response system first, then begin CPR 1
• For healthcare teams: One person begins CPR while another activates emergency response system and retrieves AED/defibrillator 1
• For pediatric victims: Provide 2 minutes of CPR before activating emergency response system if alone (due to higher likelihood of asphyxial arrest) 1

High-Quality CPR

Chest Compressions

• Rate: At least 100 compressions per minute 1
• Depth: At least 2 inches (5 cm) in adults 1
• Allow complete chest recoil after each compression 1
• Minimize interruptions to maximize perfusion 1
• Compression-to-ventilation ratio: 30:2 (for single rescuer) 1

Ventilation

• Open airway using head tilt-chin lift (jaw thrust if trauma suspected) 2
• For healthcare providers with advanced airway: Provide 1 breath every 6-8 seconds (8-10 breaths/minute) while continuing uninterrupted compressions 1
• Avoid excessive ventilation which can impede cardiac output 1, 2

Defibrillation

AED/Defibrillator Use

1. Turn on the AED as soon as available 1
2. Follow AED prompts 1
3. Resume chest compressions immediately after shock (minimize interruptions) 1
4. Continue CPR for 2 minutes between rhythm checks 1

Special Considerations

Tracheostomy Management

If patient has a tracheostomy:

• Remove any attachments (speaking valves, caps, humidifiers) 1, 2
• Apply high-flow oxygen to both face and tracheostomy stoma 2
• Attempt to pass suction catheter; if unsuccessful, replace tracheostomy tube 1, 2
• Use waveform capnography to confirm proper airway placement 1, 2

Airway Obstruction

• For conscious victims: Deliver abdominal thrusts (Heimlich maneuver) 2
• For unconscious victims: Begin CPR starting with chest compressions 2
• Look in mouth before ventilation attempts and remove visible objects 2
• Avoid blind finger sweeps 2

Team Coordination

Role Assignment

• Team leader: Coordinates response and decision-making
• Compressor: Performs chest compressions with rotation every 2 minutes to prevent fatigue
• Airway manager: Maintains patent airway and provides ventilation
• Medication/equipment manager: Prepares necessary medications and equipment
• Recorder: Documents interventions and patient response

Communication

• Use closed-loop communication (orders are repeated back)
• Announce timing of compressions (e.g., "2 minutes of CPR completed")
• Clearly communicate findings and interventions

Common Pitfalls to Avoid

• Delaying CPR to check for pulse beyond 10 seconds 1, 2
• Interrupting chest compressions unnecessarily 1
• Providing inadequate compression depth or rate 1
• Relying solely on pulse oximetry without assessing ventilation 2
• Failing to recognize agonal gasps as a sign of cardiac arrest 1
• Not using waveform capnography when available for confirming proper airway placement 1, 2

Equipment Preparation

Essential Equipment

• Basic airway equipment: Oxygen masks, self-inflating bags, oral/nasal airways 1
• Advanced airway equipment: Laryngeal mask airways, laryngoscopes with appropriate tubes 1
• Monitoring equipment: Waveform capnography, pulse oximetry 1, 2
• Emergency medications 1
• Personal protective equipment (gloves, masks, eye protection) 1

By following this systematic approach to rapid response situations, healthcare providers can optimize patient outcomes by prioritizing the most life-threatening problems first and providing timely, high-quality interventions based on the latest evidence-based guidelines.