The attending of record (or night hospitalist after 7PM) MUST be contacted for any critical change in the patient’s condition, including but not limited to:
- Upgrade to higher level of care (e.g. stepdown or ICU)
- Unanticipated change in mental status
- Significant new abnormality in vital signs
- (e.g., BP < 90 or drop of 30mm Hg, HR < 50 or HR > 130, O2 sat decrease to < 90%, O2 > 4 LMP NC)
- Significant new lab abnormality
- (e.g. K > 6, Na < 120, pH < 7.25, lactate > 4, bicarb < 12, hemoglobin drop > 3gm)
- Any new or suspected acute emergent condition
- (e.g., cord compression, bowel perforation, acute coronary syndrome)
- Unexpected death
- Procedure requiring consent
- Change in code status
- Disagreement regarding plan of care (with patient, family, or consultants)
- AMA discharge
- New admissions in RESUS or requiring stepdown
- Any event, preventable or non-preventable, that results in harm to a patient
- Any situation in which an intern or resident feels uncomfortable or has a concern
Rapid Response Team (RRT) is available 24/7 to assist with sick patients at pager 1RRT/1778. See RRT section for full details.