Trigger Tool:

Step 1

4 Categories/11 Triggers

	Documentation Triggers
1	Missing, incomplete, or unclear documentation for the following: chief complaint, physical assessment, vital signs, hemodynamic monitoring (e.g., ETC02), allergies, pertinent history or medications, patient condition at handoff of facility.
	Operational & Patient Movement Triggers
2	Time from initial patient contact to transfer of care exceeds accepted standards.
3	Injury to patient or team member during patient encounter / transport (e.g., stretcher drop, needle stick, or other).
4	Request for additional resources, personnel, or supervisor due to change in patient condition.
	Patient Condition Triggers
5	A worsening trend (deterioration) in patient hemodynamic or mental status indicators (e.g., vital signs, LOC, GCS score).
6	Cardiac arrest during transport.
	Intervention & Medication Triggers
7	Use of any of the following interventions during patient care: (cardioversion, defibrillation, transcutaneous pacing, advanced airway attempt, surgical airway, Intraosseous (IO), chest decompression, chest tube).
8	Failure of any intervention or procedure during patient care (some examples include: inability to obtain vascular access after a reasonable amount of time or number of attempts, failed IO, failed Nasogastric Tube (NG) placement, failed Foley placement, failed cardioversion, failed defibrillation, failed transcutaneous pacing, failed advanced airway or rescue airway, failed surgical airway, failed chest decompression).
9	Use of following medications or fluids: (blood products, vasopressors or inotrope [e.g., dobutamine, dopamine], naloxone, RSI medications [e.g., succinylcholine]).
10	Suggestive evidence of deviation from standard of care by performing an intervention or administering a medication that appears to be outside of protocol, or failure to perform an intervention or provide a medication that is within the standard of care.
11	Medication error (e.g., administering wrong or unapproved dose, administering wrong or unapproved medication, administering medication via wrong or unapproved route).