Open Sim Lab
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A threshold met, and a call not made

Educational use only. Not clinically reviewed

73-year-old man for calm criteria recording, obstacle naming, escalation on a threshold, and handoff practice. About 7 simulated minutes.

What you will practise

  • Record criteria that are already met.
  • Name the obstacles as non-clinical.
  • Call on the threshold, without seeking permission.
  • State the concern to a person, in words.
  • Review the boundaries and their certainty.
  • Hand off a call made on a threshold.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • Difonzo M. Performance of the Afferent Limb of Rapid Response Systems in Managing Deteriorating Patients: A Systematic Review. Crit Care Res Pract. 2019;2019:6902420. Afferent limb failure in 22.8% and delayed calls in 30.2% of adverse events in the studies reviewed; staff believed the situation was under control in 51.8% of missed activations; 75.9% of nurses called a physician first rather than the rapid response team.
  • Johnston MJ, Arora S, King D, et al. A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery. Surgery. 2015;157(4):752-763. Failure-to-rescue incidence 8.0% to 16.9%; delayed escalation reported in 20.7% to 47.1% of cases.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.