Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/62807
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Type: Journal article
Title: Triggers for emergency team activation: A multicenter assessment
Author: Chen, J.
Bellomo, R.
Hillman, K.
Flabouris, A.
Finfer, S.
Citation: Journal of Critical Care, 2010; 25(2):1-7
Publisher: W B Saunders Co
Issue Date: 2010
ISSN: 0883-9441
1557-8615
Statement of
Responsibility: 
Jack Chen, Rinaldo Bellomo, Ken Hillman, Arthas Flabouris, Simon Finfer, the MERIT Study Investigators for the Simpson Centre and the ANZICS Clinical Trials Group
Abstract: PURPOSE: The purpose of the study was to examine triggers for emergency team activation in hospitals with or without a medical emergency team (MET) system. MATERIALS AND METHODS: Within a cluster randomized controlled trial examining the effect of introducing a MET system, we recorded the triggers for emergency team activation. We compared the proportion and rate of such triggers in hospitals with or without a MET system and in relation to type of hospital, type of patient ward, and time of day. RESULTS: In control hospitals, the most common trigger for emergency team activation was a decrease in Glasgow Coma Score by 2 or more points (45.6%), whereas in MET hospitals, it was the fact that staff members were "worried" or the call occurred despite the lack of a "specified reason" (39.3%). In particular, MET hospitals were 35 times more likely to make a call because of staff being "worried" about the patient (14.1% vs 0.4%, P < .001). Control hospitals were also significantly more likely to call an emergency team because of a deteriorating respiratory (P = .003) or pulse (P < .001) rate, more calls had at least 3 triggers for activation (20.8% vs 10.2%, P = .036), and the average number of triggers per call was significantly higher (P = .013). Nonmetropolitan hospitals were more likely to call an emergency team because of respiratory rate abnormalities (33.6% vs 23.2%, P = .015). Coronary care unit calls were more likely to be triggered by abnormalities in pulse rate and systolic blood pressure, and more calls occurred during the period from 6:00 am to noon. CONCLUSIONS: In MET hospitals, more emergency team calls are triggered because staff members are worried about the patient; and fewer calls have multiple triggers. Type of hospital, type of ward, and time of day also affect the nature and frequency of triggers for emergency team activation.
Keywords: Medical emergency team; Rapid response system; Rapid response team; Critical care
Rights: Copyright © 2010 Elsevier Inc. All rights reserved.
RMID: 0020101299
DOI: 10.1016/j.jcrc.2009.12.011
Appears in Collections:Anaesthesia and Intensive Care publications

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