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It is important to always keep the patient (and, if appropriate, the family) informed of what is happening as you escalate your concerns. The patient may well be aware of the concerns you have, and this can result in fear. Fear is usually a natural response to a real danger. Most of us have experienced it at one time or another. Fear can disrupt our lives.

Table 7.2 An overview of the RSVP escalation method.

RSVP ELEMENT	ACTIONS	EXAMPLE
Reason	State your name and role and confirm who you are talking to. Give the patient’s name and location. Give the reason for the call.	My name is Janusz Nowak; I’m a nursing associate. I’m calling about a patient, Jane Doe, on Ward 1, who is experiencing chest pain currently.
Story	Give the background information about the patient, reason for admission, relevant past medical history and resuscitation status.	Jane is an 85‐year‐old female admitted two days ago with raised troponin test leading to a diagnosis of non‐ST elevation myocardial infarction. She is awaiting an inpatient angiogram. Her past medical history is hypertension and angina. Her resuscitation status was assessed yesterday and she is for resuscitation.
Vital Signs	Give abnormal vital signs as well as sign/symptoms and a description of your visual assessment of the patient.	She appears pale and her skin is clammy. She is tachypnoeic with a respiration rate of 28, tachycardic with a heart rate of 112, with a weak, palpable radial pulse. She is hypotensive with a blood pressure of 92/56. All other observations are within normal parameters. Her total NEWS score is 7.
Plan	Give your current plan and ask for a further plan from the recipient. Ask now for anything you want them to do.	We are going to connect to a monitor and complete serial ECGs. Please come and assess this patient immediately.