Medical emergency teams: A role for expanding intensive care?

A. Åneman*, M. Parr

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

Background: A high incidence of preventable adverse events and deaths in hospitals has triggered initiatives to improve the quality of care of acutely ill in-hospital patients. System changes involving the introduction of medical emergency teams, outreach services or rapid response teams are an integral part of these initiatives. The rationale for implementing a designated team is that early recognition and rapid institution of adequate therapy for the deteriorating patient can improve outcome. The concept of bringing intensive care expertise to any acutely ill patient irrespective of location within the hospital is envisioned as "critical care without walls". Methods: Studies were identified by a PubMed search and cited references in key publications provided additional material including www-resources. More than 80 studies were identified and selected for review, however, no formal search strategy for a systematic review or meta-analysis was attempted. Only studies published in English were considered. Results: Several non-randomized, before-and-after cohort studies demonstrate that implementation of medical emergency teams and equivalents can reduce the incidence of cardiac arrests, unexpected deaths, and unplanned intensive care admissions. However, one recent randomized, controlled trial of medical emergency teams failed to demonstrate any differences in outcomes. Conclusion: Several key operational issues need to be addressed before introducing medical emergency response teams based on current evidence. These issues include differences in healthcare systems and performance, patient case-mix, resources available, composition of the teams and calling criteria, and strategies for education, audit and governance.

Original languageEnglish
Pages (from-to)1255-1265
Number of pages11
JournalActa Anaesthesiologica Scandinavica
Volume50
Issue number10
DOIs
Publication statusPublished - Nov 2006

Keywords

  • Intensive care
  • Medical emergency team
  • Outreach service
  • Rapid response team
  • Resuscitation

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