Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study

2014 ◽  
Vol 22 (5) ◽  
pp. 223-228 ◽  
Author(s):  
Anna Aftyka ◽  
Beata Rybojad ◽  
Ewa Rudnicka-Drozak
Keyword(s):  
Cohort Study ◽  
Urban Areas ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Single Centre ◽  
Emergency Team ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Team Interventions

scholarly journals The Medical Emergency Team

1995 ◽  
Vol 23 (2) ◽  
pp. 183-186 ◽  
Author(s):  
A. Lee ◽  
G. Bishop ◽  
K. M. Hillman ◽  
K. Daffurn
Keyword(s):  
Cardiopulmonary Arrest ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team ◽  
Patients At Risk ◽  
Medical Emergencies ◽  
One Year ◽  
Seriously Ill Patients ◽  
Team Interventions ◽  
Seriously Ill

The concept of a Medical Emergency Team was developed in order to rapidly identify and manage seriously ill patients at risk of cardiopulmonary arrest and other high-risk conditions. The aim of this study was to describe the utilization and outcome of Medical Emergency Team interventions over a one-year period at a teaching hospital in South Western Sydney. Data was collected prospectively using a standardized form. Cardiopulmonary resuscitation occurred in 148/522 (28%) calls. Alerting the team using the specific condition criteria occurred in 253/522 (48%) calls and on physiological/pathological abnormality criteria in 121/522 (23%) calls. Survival rate to hospital discharge following cardiopulmonary arrest was low (29%), compared with other medical emergencies (76%).

scholarly journals Observational cohort study of the triggers, diagnoses and outcomes of the medical emergency team (MET) response in adult psychiatry inpatients colocated with acute medical services in Australia

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046110
Author(s):  
Meor Azraai ◽  
Jeanette H Pham ◽  
Wenye F Looi ◽  
Daniel Wirth ◽  
Ashley S L Ng ◽  
...  
Keyword(s):  
Cohort Study ◽  
Adverse Effects ◽  
Medical Emergency Team ◽  
Final Diagnosis ◽  
Medical Emergency ◽  
Medical Services ◽  
Secondary Outcome ◽  
Emergency Team ◽  
Risk Of Death ◽  
Drug Adverse Effects

ObjectivesMedical emergencies in psychiatric inpatients are challenging due to the model of care and limited medical resources. The study aims were to determine the triggers and outcomes of a medical emergency team (MET) call in psychiatric wards, and the risk factors for MET activation and mortality.DesignRetrospective multisite cohort study.SettingPsychiatry units colocated with acute medical services at three major metropolitan hospitals in Melbourne, Australia.ParticipantsWe studied 487 adult inpatients who experienced a total of 721 MET calls between January 2015 and January 2020. Patients were relatively young (mean age, 45 years) and had few medical comorbidities, but a high prevalence of smoking, excessive alcohol intake and illicit drug use.Outcome measuresWe performed a descriptive analysis of the triggers and outcomes (transfer rates, investigations, final diagnosis) of MET calls. We used logistic regression to determine the factors associated with the primary outcome of inpatient mortality, and the secondary outcome of the need for specific medical treatment compared with simple observation.ResultsThe most common MET triggers were a reduced Glasgow Coma Scale, tachycardia and hypotension, and 49% of patients required transfer. The most frequent diagnosis was a drug adverse effect or toxidrome, followed by infection and dehydration. There was a strong association between a leave of absence and MET calls, tachycardia and the final diagnosis of drug adverse effects. Mortality occurred in 3% after MET calls. Several baseline and MET clinical variables were associated with mortality but a model with age (per 10 years, OR 1.61, 95% CI 1.29 to 2.01) and hypoxia (OR 3.59, 95% CI 1.43 to 9.04) independently predicted mortality.ConclusionVigilance is required in patients returning from day leave, and drug adverse effects remain a challenging problem in psychiatric units. Hypoxic older patients with cardiovascular comorbidity have a higher risk of death.

scholarly journals Predictive Value of Quick Sepsis-Related Organ Failure Scores following Sepsis-Related Medical Emergency Team Calls: A Retrospective Cohort Study

2017 ◽  
Vol 45 (6) ◽  
pp. 688-694 ◽  
Author(s):  
D. Boulos ◽  
Y. Shehabi ◽  
J. A. Moghaddas ◽  
M. Birrell ◽  
A. Choy ◽  
...  
Keyword(s):  
Cohort Study ◽  
Organ Failure ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Multi Drug Resistance ◽  
Causative Organism ◽  
Suspected Sepsis ◽  
Emergency Team ◽  
Tertiary Centre ◽  
Qsofa Score

We conducted a cohort study of adult ward patients who had a Medical Emergency Team (MET) call triggered by confirmed or suspected sepsis in an Australian tertiary centre to assess the predictive utility of systemic inflammatory response syndrome (SIRS) and quick Sepsis-Related Organ Failure Assessment (qSOFA) scores for 28-day mortality over a 12-month period. Sepsis was the causative aetiology in 970 MET calls for 646 patients with a mean age of 68 years and median Charlson Comorbidity score (CCS) of 3.0. Four hundred and seven (63%) patients had microbiological identification of a causative organism with 35 (9%) demonstrating multi–drug resistance. The 28-day mortality rate was 22%. Independent risk factors for 28-day mortality included age (incidence rate ratio [IRR] 1.038; P <0.001) and CCS (IRR 1.102; P <0.001). qSOFA positive patients had a threefold risk of 28-day mortality compared to those who were negative (IRR 3.15; P=0.02). Both the SIRS and qSOFA score had poor sensitivity (86% versus 62%, respectively) for mortality as a sole diagnostic tool and should be investigated as part of a multiparameter panel within a large prospective study.

scholarly journals Comparison of the National Early Warning Scores and Rapid Emergency Medicine Scores with the APACHE II Scores as a Prediction of Mortality in Patients with Medical Emergency Team Activation: A Single-centre Retrospective Cohort Study

2021 ◽  
Vol 7 (4) ◽  
pp. 283-289
Author(s):  
Junpei Haruna ◽  
Hiroomi Tatsumi ◽  
Satoshi Kazuma ◽  
Hiromitsu Kuroda ◽  
Yuya Goto ◽  
...  
Keyword(s):  
Early Warning ◽  
Retrospective Cohort ◽  
Screening Tool ◽  
Medical Emergency Team ◽  
General Ward ◽  
Apache Ii ◽  
Medical Emergency ◽  
Apache Ii Score ◽  
Single Centre ◽  
Emergency Team

Abstract Introduction The medical emergency team enables the limitation of patients’ progression to critical illness in the general ward. The early warning scoring system (EWS) is one of the criteria for medical emergency team activation; however, it is not a valid criterion to predict the prognosis of patients with MET activation. Aim In this study, the National Early Warning Score (NEWS) and Rapid Emergency Medicine Score (REMS) was compared with that of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in predicting the prognosis of patients who had been treated a medical emergency team. Material and Methods In this single-centre retrospective cohort study, patients treated by a medical emergency team between April 2013 and March 2019 and the 28-day prognosis of MET-activated patients were assessed using APACHE II, NEWS, and REMS. Results Of the 196 patients enrolled, 152 (77.5%) were men, and 44 (22.5%) were women. Their median age was 68 years (interquartile range: 57-76 years). The most common cause of medical emergency team activation was respiratory failure (43.4%). Univariate analysis showed that APACHE II score, NEWS, and REMS were associated with 28-day prognostic mortality. There was no significant difference in the area under the receiver operating characteristic curve of APACHE II (0.76), NEWS (0.67), and REMS (0.70); however, the sensitivity of NEWS (0.70) was superior to that of REMS (0.47). Conclusion NEWS is a more sensitive screening tool like APACHE II than REMS for predicting the prognosis of patients with medical emergency team activation. However, because the accuracy of NEWS was not sufficient compared with that of APACHE II score, it is necessary to develop a screening tool with higher sensitivity and accuracy that can be easily calculated at the bedside in the general ward.

Sign in / Sign up

Export Citation Format

Share Document