Marjon Borgert

49 Emergency care for false arrests The CAT is responsible for patients who su er fromcardiac arrests or with an unexpected or suspected life-threatening medical emergency. The CAT attends to the patient within 2 minutes after activation. Rapid Response Team (RRT) The RRT is part of a system; the Rapid Response System (RRS). The RRS aims to detect and treat deteriorating patients on general wards and to prevent them from su ering an AE. 2,3 The rst step of the RRS protocol is the detection of deteriorating patients. A commonly used instrument to detect these patients by measuring vital signs is the MEWS. 4,5 The Dutch MEWS incorporates eight vital signs or parameters (Table 1). Each parameter has a standardised range of cut-o points. Prede nedweighted trigger scores should be allocated to each recorded parameter. Nurses should record all 8 parameters for a correct completion of the MEWS. According to the two-tiered Dutch system, the RRS-protocol dictates that when reaching a prede ned threshold, the nurse has to notify the physician on duty on the ward. The physician must assess the patient within 30 minutes and could either initiate treatment or activate the RRT instantly. 6 In case the clinical condition is not improving or if the physician is not able to assess the patient, it is the nurse who must activate the RRT. The RRT consist of an ICU fellow and ICU nurse and is 24/7 available. They attend to the patient within 10 minutes of activation. Training in emergency care Nurses are trained in Basic Life Support (BLS), which includes training in: 1) recognizing cardiac arrests; 2) call for help and activate the CAT; 3) acting as a rst responder and start resuscitation. Nurses are required to follow the BLS retraining every 3 years. In September 2011 the RRS protocol was implemented in our hospital. All nurses and physicians on the wards were trained in measuring the MEWS and in activating the RRT. New nursing employees are trained in the RRS protocol on the nursing wards by senior nurses specialised in quality improvement.