scholarly journals Characteristics and outcomes of children receiving intensive care therapy within 12 hours following a medical emergency team event

2021 ◽  
Vol 23 (3) ◽  
pp. 254-261
Author(s):  
Ben Gelbart ◽  
◽  
Suzanna Vidmar ◽  
David Stephens ◽  
Daryl Cheng ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Medical Emergency Team ◽  
Risk Difference ◽  
Respiratory Support ◽  
Medical Emergency ◽  
Critical Event ◽  
Positive Pressure ◽  
Intensive Care Therapy ◽  
Emergency Team

OBJECTIVES: To describe characteristics and outcomes of children requiring intensive care therapy (ICT) within 12 hours following a medical emergency team (MET) event. DESIGN: Retrospective cohort study. SETTING: Quaternary paediatric hospital. PATIENTS: Children experiencing a MET event. MEASUREMENTS AND MAIN RESULTS: Between July 2017 and March 2019, 890 MET events occurred in 566 patients over 631 admissions. Admission to intensive care followed 183/890 (21%) MET events. 76/183 (42%) patients required ICT, defined as positive pressure ventilation or vasoactive support in intensive care, within 12 hours. Older children had a lower risk of requiring ICT than infants aged < 1 year (age 1–5 years [risk difference, -6.4%; 95% CI, -11% to -1.6%; P = 0.01] v age > 5 years [risk difference, -8.0%; 95% CI, -12% to -3.8%; P < 0.001]), while experiencing a critical event increased this risk (risk difference, 16%; 95% CI, 3.3–29%; P = 0.01). The duration of respiratory support and intensive care length of stay was approximately double in patients requiring ICT (ratio of geometric means, 2.0 [95% CI, 1.4–3.0] v 2.1 [95% CI, 1.5–2.8]; P < 0.001) and the intensive care mortality increased (risk difference, 9.6%; 95% CI, 2.4–17%; P = 0.01). Heart rate, oxygen saturation and respiratory rate were the most commonly measured vital signs in the 6 hours before the MET event. CONCLUSIONS: Approximately one-fifth of MET events resulted in intensive care admission and nearly half of these required ICT within 12 hours. This group had greater duration of respiratory support, intensive care and hospital length of stay, and higher mortality. Age < 1 year and a critical event increased the risk of ICT.

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

Rates of in‐hospital arrests, deaths and intensive care admissions: the effect of a medical emergency team

2000 ◽  
Vol 173 (5) ◽  
pp. 236-240 ◽  
Author(s):  
Peter J Bristow ◽  
Ken M HIiiman ◽  
Kathy Daffum ◽  
Sandra L Norman ◽  
Gillian F Bishop ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team

Is postoperative intensive care unit admission a prerequisite for elective craniotomy?

2011 ◽  
Vol 115 (6) ◽  
pp. 1236-1241 ◽  
Author(s):  
John Q. H. Bui ◽  
Rajith L. Mendis ◽  
James M. van Gelder ◽  
Mark M. P. Sheridan ◽  
Kylie M. Wright ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Loss ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Safe Alternative ◽  
Emergency Team ◽  
Icu Admission ◽  
Postoperative Intensive Care ◽  
Postoperative Intensive Care Unit

Object Routine postoperative admission to the intensive care unit (ICU) is often considered a necessity in the treatment of patients following elective craniotomy but may strain already limited resources and is of unproven benefit. In this study the authors investigated whether routine postoperative admission to a regular stepdown ward is a safe alternative. Methods Three hundred ninety-four consecutive patients who had undergone elective craniotomy over 54 months at a single institution were retrospectively analyzed. Indications for craniotomy included tumor (257 patients) and transsphenoidal (63 patients), vascular (31 patients), ventriculostomy (22 patients), developmental (13 patients), and base of skull conditions (8 patients). Recorded data included age, operation, reason for ICU admission, medical emergency team (MET) calls, in-hospital mortality, and postoperative duration of stay. Results Three hundred forty-three patients were admitted to the regular ward after elective craniotomy, whereas there were 43 planned and 8 unplanned ICU admissions. The most common reasons for planned ICU admissions were anticipated lengthy operations (42%) and anesthetic risks (40%); causes for unplanned ICU admissions were mainly unexpected slow neurological recovery and extensive intraoperative blood loss. Of the 343 regular ward admissions, 10 (3%) required a MET call; only 3 of these MET calls occurred within the first 48 postoperative hours and did not lead to an ICU admission. The overall mortality rate in the investigated cohort was 1%, with no fatalities in patients admitted to the normal ward postoperatively. Conclusions Routine ward admission for patients undergoing elective craniotomies with selective ICU admission appears safe; however, approximately 2% of patients may require a direct postoperative unplanned ICU admission. Patients with anticipated long operation times, extensive blood loss, and high anesthetic risks should be selected for postoperative ICU admission, but further study is needed to determine the preoperative factors that can aid in identifying and caring for these groups of patients.

Medical emergency team may reduce obstetric intensive care unit admissions

2016 ◽  
Vol 43 (1) ◽  
pp. 106-113 ◽  
Author(s):  
Moon Seong Baek ◽  
Jeongsuk Son ◽  
Jin Won Huh ◽  
Chae-Man Lim ◽  
Younsuck Koh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team

scholarly journals Medical emergency team admittance to intensive care versus conventional admittance: characteristics and outcome

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
G Jäderling ◽  
M Bell ◽  
CR Martling ◽  
A Ekbom ◽  
M Bottai ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team

Increased Mortality and Length of Stay Associated With Medical Emergency Team Review in Hospitalized Pediatric Patients

2017 ◽  
Vol 18 (6) ◽  
pp. 571-579 ◽  
Author(s):  
Brianna McKelvie ◽  
James Dayre McNally ◽  
Jason Chan ◽  
Franco Momoli ◽  
Christa Ramsay ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pediatric Patients ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

2013 ◽  
Vol 22 (4) ◽  
pp. 314-319 ◽  
Author(s):  
Jed Lipes ◽  
Louay Mardini ◽  
Dev Jayaraman
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Medical Emergency Team ◽  
Mortality Rates ◽  
Medical Emergency ◽  
Mortality Data ◽  
Medical Patients ◽  
Emergency Team ◽  
Surgical Units ◽  
The Difference

Background After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. Objective To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. Methods A total of 241 consecutive admissions to intensive care from medical and surgical units during a 12-month period were analyzed retrospectively. Patients’ demographics, illness severity, and delay between the time the patients would have fulfilled criteria for calling a medical emergency team and consultation with and admission to intensive care were analyzed. Results Delay from fulfillment of criteria for calling a medical emergency team and consultation with intensive care and from consultation to admission to intensive care did not differ between sexes. Despite similar delays in admission to intensive care, women had a higher 30-day mortality than did men (44.9% vs 30.5%; P = .02). The increased mortality was more pronounced in the medical patients (53% vs 34%; P = .02). Multivariate analysis of mortality data yielded a mortality odds ratio of 0.35 (95% CI, 0.16–0.74) for men, significantly different from values for women (P = .006). Conclusion After admission to intensive care from medical or surgical units, women had higher mortality rates than did men, and the difference was more pronounced in medical patients. The difference in mortality between sexes was not explained by delayed recognition of critical illness or delayed admission to intensive care.

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