The Medical Emergency Team: a new strategy to identify and intervene in high-risk patients

Abstract

Objective: To describe the utilisation of an emergency team that employs standardised calling criteria to facilitate the early identification and resuscitation of patients who are at risk of cardiorespiratory arrest. Design: A prospective study of all Medical Emergency Team calls over a six-month period in 1994. Setting: A 460-bed university teaching hospital in Sydney, Australia. Subjects: Inpatients and outpatients who required Medical Emergency Team intervention. Interventions: None. Endpoints: Unplanned admission to critical care units, mortality. Measurements and main results: There was a total of 294 calls, of which 53% occurred on the wards and 31% in the Emergency Department. Cardiac arrests accounted for 24% of responses. Abnormal physiological variables were a factor in 60% of calls. Decreased level of consciousness occurred in 46% of cases. Fifty-three calls necessitated admission of patients to critical care units, of which 32 (60%) survived to hospital discharge. The mortality rate at hospital discharge was higher in cardiac arrests (84%) than other medical emergencies (27%)(χ²=51.24; pConclusions: The Medical Emergency Team is well employed as an early intervention team, with abnormal physiological variables alerting the team in many cases. A standardised team approach encouraging early medical intervention in 'at-risk' patients may potentially reduce the high morbidity and mortality associated with the seriously ill and those at risk from cardiac arrest.