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Das Konzept des Medical Emergency Team – Intensivmedizin außerhalb der Intensivstation

The concept of the medical emergency team – intensive care outside the intensive care unit

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Intensivmedizin und Notfallmedizin

Abstract

The Medical Emergency Team (MET) concept aims to bring the expertise of intensivists outside the borders of the intensive care unit. The ultimate goal is reflected as the early recognition and treatment of critically ill patients within the hospital. Easily applicable warning criteria are used to recognize a critical situation and to trigger a medical emergency team alarm. Action of the MET includes clarification of diagnostic steps and therapeutic options as well as the implementation of basic critical care measures. This article provides an overview of the reasoning, outcomes and discussions related to this concept for intrahospital emergencies.

Zusammenfassung

Das Konzept des „Medical Emergency Teams“ bringt die Expertise von Intensivmedizinern über die Grenzen der Intensivstation hinaus und zielt darauf ab im Krankenhaus frühzeitig kritische Patienten zu erkennen und zeitgerecht zu intervenieren. Zur Erkennung einer kritischen Situation werden einfach zu handhabende Kriterien eingesetzt, bei deren Erreichen das Medical Emergency Team alarmiert wird. Die Tätigkeit des Medical Emergency Teams umfasst die Abklärung von Ursachen und Therapieoptionen sowie den Einsatz einfacher intensivmedizinischer Maßnahmen vor Ort. Der vorliegende Artikel gibt einen kurzen Überblick zu Argumentation, Ergebnissen und Diskussionspunkten dieses innerklinischen Notfallkonzepts.

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Literatur

  1. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O’Hearn N, Van den Hoek TL, Becker LB (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293:305–310

    Article  PubMed  CAS  Google Scholar 

  2. Bell MB, Konrad D, Granath F, Ekbom A, Martling CR (2006) Prevalence and sensitivity of MET-criteria in a Scandinavian University Hospital. Resuscitation 70:66–73

    Article  PubMed  Google Scholar 

  3. Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart G, Opdam H, Silvester W, Doolan L, Gutteridge G (2004) Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med 32:916–921

    Article  PubMed  Google Scholar 

  4. Bellomo R, Goldsmith D, Uchino S, Buckmaster J, Hart GK, Opdam H, Silvester W, Doolan L, Gutteridge G (2003) A prospective before-and-after trial of a medical emergency team. Med J Aust 179:283–287

    PubMed  Google Scholar 

  5. Buist M, Bernard S, Nguyen TV, Moore G, Anderson J (2004) Association between clinically abnormal observations and subsequent in-hospital mortality: a prospective study. Resuscitation 62:137–141

    Article  PubMed  Google Scholar 

  6. Buist M, Harrison J, Abaloz E, Van Dyke S (2007) Six year audit of cardiac arrests and medical emergency team calls in an Australian outer metropolitan teaching hospital. BMJ 335:1210–1212

    Article  PubMed  Google Scholar 

  7. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV (2002) Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ 324:387–390

    Article  PubMed  Google Scholar 

  8. Devita MA, Bellomo R, Hillman K, Kellum J, Rotondi A, Teres D, Auerbach A, Chen WJ, Duncan K, Kenward G, Bell M, Buist M, Chen J, Bion J, Kirby A, Lighthall G, Ovreveit J, Braithwaite RS, Gosbee J, Milbrandt E, Peberdy M, Savitz L, Young L, Harvey M, Galhotra S (2006) Findings of the first consensus conference on medical emergency teams. Crit Care Med 34:2463–2478

    Article  PubMed  Google Scholar 

  9. DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL (2004) Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf Health Care 13:251–254

    Article  PubMed  CAS  Google Scholar 

  10. Gao H, McDonnell A, Harrison DA, Moore T, Adam S, Daly K, Esmonde L, Goldhill DR, Parry GJ, Rashidian A, Subbe CP, Harvey S (2007) Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med 33:667–679

    Article  PubMed  Google Scholar 

  11. Garrard C, Young D (1998) Suboptimal care of patients before admission to intensive care is caused by a failure to appreciate or apply the ABCs of life support. BMJ 316:1841–1842

    PubMed  CAS  Google Scholar 

  12. Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, Finfer S, Flabouris A (2005) Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial. Lancet 365:2091–2097

    Article  PubMed  Google Scholar 

  13. Hodgetts TJ, Kenward G, Vlachonikolis IG, Payne S, Castle N (2002) The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team. Resuscitation 54:125–131

    Article  PubMed  Google Scholar 

  14. Jacques T, Harrison GA, McLaws ML, Kilborn G (2006) Signs of critical conditions and emergency responses (SOCCER): a model for predicting adverse events in the inpatient setting. Resuscitation 69:175–183

    Article  PubMed  Google Scholar 

  15. Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Cheang M (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596

    Article  PubMed  Google Scholar 

  16. McQuillan P, Pilkington S, Allan A, Taylor B, Short A, Morgan G, Nielsen M, Barrett D, Smith G, Collins CH (1998) Confidential inquiry into quality of care before admission to intensive care. BMJ 316:1853–1858

    PubMed  CAS  Google Scholar 

  17. Nadkarni VM, Larkin GL, Peberdy MA, Carey SM, KayeW, Mancini ME, Nichol G, Lane-Truitt T, Potts J, Ornato JP, Berg RA (2006) First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA 295:50–57

    Article  PubMed  CAS  Google Scholar 

  18. Nurmi J, Harjola VP, Nolan J, Castren M (2005) Observations and warning signs prior to cardiac arrest. Should a medical emergency team intervene earlier? Acta Anaesthesiol Scand 49:702–706

    Article  PubMed  CAS  Google Scholar 

  19. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M (2001) Early goaldirected therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377

    Article  PubMed  CAS  Google Scholar 

  20. Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245

    Article  PubMed  Google Scholar 

  21. Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL (1990) Clinical antecedents to in-hospital cardiopulmonary arrest. Chest 98:1388–1392

    Article  PubMed  CAS  Google Scholar 

  22. Sebat F, Musthafa AA, Johnson D, Kramer AA, Shoffner D, Eliason M, Henry K, Spurlock B (2007) Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years. Crit Care Med 35:2568–2575

    Article  PubMed  Google Scholar 

  23. Simchen E, Sprung CL, Galai N, Zitser- Gurevich Y, Bar-Lavi Y, Gurman G, Klein M, Lev A, Levi L, Zveibil F, Mandel M, Mnatzaganian G (2004) Survival of critically ill patients hospitalized in and out of intensive care units under paucity of intensive care unit beds. Crit Care Med 32:1654–1661

    Article  PubMed  Google Scholar 

  24. Sinuff T, Kahnamoui K, Cook DJ, Luce JM, Levy MM (2004) Rationing critical care beds: a systematic review. Crit Care Med 32:1588–1597

    Article  PubMed  Google Scholar 

  25. Subbe CP, Kruger M, Rutherford P, Gemmel L (2001) Validation of a modified Early Warning Score in medical admissions. QJM 94:521–526

    Article  PubMed  CAS  Google Scholar 

  26. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ (2007) Rapid response systems: a systematic review. Crit Care Med 35:1238–1243

    Article  PubMed  Google Scholar 

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  1. Allgemeine u. Internistische Intensivstation, II. Medizinische Abteilung, KA Rudolfstiftung, Juchgasse 25, 1030, Wien, Austria

    Andreas Valentin

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  1. Andreas Valentin
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Correspondence to Andreas Valentin.

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Valentin, A. Das Konzept des Medical Emergency Team – Intensivmedizin außerhalb der Intensivstation. Intensivmed 45, 217–221 (2008). https://doi.org/10.1007/s00390-008-0885-9

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  • DOI: https://doi.org/10.1007/s00390-008-0885-9

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