Notify the provider per the patient-specific parameters and agency policy, and document the closed loop — contact, content, response, and follow-through.
State the specific parameter that was met (the value or finding that triggered notification).
Record the date and time of contact, who was notified, exactly what was reported, the response or orders received, and the follow-through.
If a response is pending, document the scheduled follow-up time so the loop is not left open.
Common notification triggers for this system: a newly diminished or absent pulse; a cooling, pale, or mottled extremity; new unilateral calf swelling, warmth, or tenderness (possible deep-vein thrombosis); acute severe extremity pain; a new or worsening ulcer; or signs of major bleeding on anticoagulation.
Closed-loop example
“Provider notified at 14:30 of a newly diminished right dorsalis pedis and posterior tibial pulse (1+ from 2+), a cooler and paler right foot, delayed capillary refill, and new pain. Given the acute change, urgent evaluation was directed and emergency medical services activated for possible acute limb ischemia; the limb was maintained per the patient-specific order while awaiting EMS, with serial neurovascular checks documented pending transport and follow-up to coordinate care and reassess on return.”
