MRT

1. MRT Medical Response Team

2. Greg Thompson Joy Erb Moser Barb Johnson Theresa Bender Rhonda Larson Linda Groon Chuck Schauberger Mary Jo Klos Judy Pronk Chris Heiderscheit Sanjay Cheulkar Stephen Shapiro Tom Klemond Lynn Lenz Development Team

3. Purpose of an MRT To improve patient care at Gundersen Lutheran through early identification and intervention on behalf of patients experiencing medical emergencies.

4. Med Surg Code Blue Survival Rate

5. Med Surg Discharge Alive After Code Blue Rate

6. MRT Members •  Hospital Operations Manager •  Respiratory Therapist • Hospitalist *No hospitalist coverage from 6pm to 9pm • Person carrying pager 6666. 0730-1530 GM 5 staff 1530-2130 Sr Resident on call or GM staff 2130-0730 Night Hospitalist

7. MRT Activation Criteria AIRWAY/BREATHING New, unexpected or symptomatic threatened airway OR respiratory distress: • Respiratory rate < 6 / minute or > 30 / minute • Oxygen saturations < 88% despite maximum oxygen therapy • Stridorous respirations, trach pulled out, aspiration

8. Activation Criteria (cont) CIRCULATION New, unexpected or symptomatic: • Pulse rate < 40 / minute or > 130 / minute • Systolic blood pressure < 90 DISABILITY Acute change in level of consciousness

9. Other Activation Criteria • Nurse is concerned about patient’s status and primary service is unavailable. • Patient is 18 years and older.

10. Activate Code Team if : • No respirations • No pulse • No blood pressure • Loss of consciousness • Unsure whether to call MRT or Code Team

11. Departments MRT will respond: • 6 West • 4 Center • 3 West • 3 Center • Inpatient Rehab • OB/GYN • 4 West (for patients > 18)

12. Method to Activate Dial 99 and instruct the operator to page the Medical Response Team (MRT). The attending physician needs to be paged in conjunction with activating the MRT.

13. MRT Interventions • Activating oxygen protocols • Rhythm monitoring • IV therapy • VS monitoring • Patient transfer * The staff nurse assigned to the patient will remain the patient’s primary care provider during MRT activation.

14. Nursing Documentation A nurse’s note and the appropriate patient care flow sheets documenting patient status leading to activation of the MRT along with patient response to interventions will be completed by the nursing staff assigned to the patient.

15. Physician Documentation MRT Interventions will be documented in the patient progress notes by either the Hospitalist Primary Service or Resident responding to the call.

16. Data Collection The Hospital Operations Manager or Respiratory Therapist will complete the MRT data collection tool.

17. Other Roles HUC-Will stamp data collection form when MRT is activated. Runner- A staff member designated to bring the Lifepak or telemon into the patients room.

18. Lifepak locations • 6 West-has own Lifepak • OB/GYN-will send runner to Labor and Delivery • 4 Center-has own Lifepak • 4 West-will send runner to 4 Center • 3 Center-will use their telemon • 3 West-has own Lifepak • Inpatient Rehab-will send runner to 3 West

19. When not to activate the MRT-- • For routine orders • For second opinions

20. Start Date Monday, November 1st 7am

21. Questions??????