Point-of-care testing during medical emergency team activations: A pilot study

Resuscitation ◽  
2012 ◽  
Vol 83 (9) ◽  
pp. 1119-1123 ◽  
Author(s):  
P. Calzavacca ◽  
E. Licari ◽  
A. Tee ◽  
R. Bellomo
Keyword(s):  
Pilot Study ◽  
Point Of Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Point Of Care Testing ◽  
Emergency Team

scholarly journals Automated detection of physiologic deterioration in hospitalized patients

2014 ◽  
Vol 22 (2) ◽  
pp. 350-360 ◽  
Author(s):  
R Scott Evans ◽  
Kathryn G Kuttler ◽  
Kathy J Simpson ◽  
Stephen Howe ◽  
Peter F Crossno ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Point Of Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Surgical Trauma ◽  
Emergency Team ◽  
Charge Nurses ◽  
Large Level ◽  
Level 1 ◽  
Level 1 Trauma Center

Abstract Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help.

scholarly journals A point-of-care thoracic ultrasound protocol for hospital medical emergency teams (METUS) improves diagnostic accuracy

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Blans M.J ◽  
Bousie E ◽  
Hoeven van der J.G ◽  
Bosch F.H
Keyword(s):  
Point Of Care ◽  
Correct Diagnosis ◽  
Medical Emergency Team ◽  
Final Diagnosis ◽  
Medical Emergency ◽  
Point Of Care Ultrasound ◽  
Emergency Team ◽  
Medical Emergency Teams ◽  
The Us ◽  
Few Data

Abstract Background Point-of-care ultrasound (POCUS) has proven itself in many clinical situations. Few data on the use of POCUS during Medical Emergency Team (MET) calls exist. In this study, we hypothesized that the use of POCUS would increase the number of correct diagnosis made by the MET and increase MET’s certainty. Methods Single-center prospective observational study on adult patients in need for MET assistance. Patients were included in blocks (weeks). During even weeks, the MET physician performed a clinical assessment and registered an initial diagnosis. Subsequently, the POCUS protocol was performed and a second diagnosis was registered (US+). During uneven weeks, no POCUS was performed (US−). A blinded expert reviewed the charts for a final diagnosis. The number of correct diagnoses was compared to the final diagnosis between both groups. Physician’s certainty, mortality and possible differences in first treatment were also evaluated. Results We included 100 patients: 52 in the US + and 48 in the US−  group. There were significantly more correct diagnoses in the US+ group compared to the US− group: 78 vs 51% (P  = 0.006). Certainty improved significantly with POCUS (P  <  0.001). No differences in 28-day mortality and first treatment were found. Conclusions The use of thoracic POCUS during MET calls leads to better diagnosis and increases certainty. Trial registration. ClinicalTrials.gov. Registered 12 July 2017, NCT03214809 https://www.clinicaltrials.gov/ct2/show/NCT03214809?term=metus&cntry=NL&draw=2&rank=1

scholarly journals Urgent Ultrasound Guided Hemodynamic Assessments by a Pediatric Medical Emergency Team: A Pilot Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (6) ◽  
pp. e66951 ◽  
Author(s):  
David J. Zorko ◽  
Karen Choong ◽  
Jonathan Gilleland ◽  
Barbara Agar ◽  
Shawn Baker ◽  
...  
Keyword(s):  
Pilot Study ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Ultrasound Guided ◽  
Emergency Team

Comparison of policies for recognising and responding to clinical deterioration across five Victorian health services

2018 ◽  
Vol 42 (4) ◽  
pp. 412 ◽  
Author(s):  
Julie Considine ◽  
Anastasia F. Hutchison ◽  
Helen Rawson ◽  
Alison M. Hutchinson ◽  
Tracey Bucknall ◽  
...  
Keyword(s):  
Patient Safety ◽  
Health Services ◽  
Medical Emergency Team ◽  
National Standards ◽  
Clinical Deterioration ◽  
Medical Emergency ◽  
Emergency Team ◽  
Subacute Care ◽  
Guidance Documents ◽  
Activation Criteria

Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia. Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes. Results In all, 22 guidance documents and five graphic observation and response charts were reviewed. Variation was observed in terminology, content and recommendations between the health services. Most health services’ definitions of physiological observations fulfilled national standards in terms of minimum parameters and frequency of assessment. All health services had three-tier rapid response systems (RRS) in place at both acute and subacute care sites, consisting of activation criteria and an expected response. RRS activation criteria varied between sites, with all sites requiring modifications to RRS activation criteria to be made by medical staff. All sites had processes for patient and family escalation of care. Conclusions Current guidance documents related to the frequency of observations and escalation of care omit the vital role of nurses in these processes. Inconsistencies between health services may lead to confusion in a mobile workforce and may reduce system dependability. What is known about the topic? Recognising and responding to clinical deterioration is a major patient safety priority. To comply with national standards, health services must have systems in place for recognising and responding to clinical deterioration. What does this paper add? There is some variability in terminology, definitions and specifications of physiological observations and medical emergency team (MET) activation criteria between health services. Although nurses are largely responsible for physiological observations and escalation of care, they have little authority to direct frequency of observations and triggers for care escalation or tailor assessment to individual patient needs. Failure to identify nurses’ role in policy is concerning and contrary to the evidence regarding nurses and MET activations in practice. What are the implications for practitioners? Inconsistencies in recommendations regarding physiological observations and escalation of care criteria may create patient safety issues when students and staff work across organisations or move from one organisation to another. The validity of other parameters, such as appearance, pain, skin colour and cognition, warrant further consideration as early indicators of deterioration that may be used by nurses to identify clinical deterioration earlier. A better understanding of the relationship between the sensitivity, specificity and frequency of monitoring of particular physiological observations and patient outcomes is needed to improve the predictive validity for identification of clinical deterioration.

Features of an Intensive Care based Medical Emergency Team nurse training program in a University Teaching Hospital

2016 ◽  
Vol 29 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Michelle Topple ◽  
Brooke Ryan ◽  
Richard McKay ◽  
Damien Blythe ◽  
John Rogan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Training Program ◽  
Teaching Hospital ◽  
Medical Emergency Team ◽  
University Teaching ◽  
Medical Emergency ◽  
Nurse Training ◽  
Emergency Team
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