A framework for approaching a MET call as an ICU registrar

  • INTRODUCTIONS: 
    • ​Introduce yourself with name and rank to the patient and team
  • REASON:
    • Determine reason for MET activation
  • LIMITATIONS OF CARE?:
    • Determine level of resuscitation status and goals of care
  • ESTABLISH ROLES, TASKS AND RESOURCES:
    • Actively determine leadership (medical registrar) and followership roles and engage team
    • Allocate team members to rapid cardiorespiratory assessment and intravenous access
    • Determine physical and staff resources available (request more early if needed)
  • INFORMATION GATHERING:
    • Obtain a summarised history from the treating team members
    • Review patient verbal history (if possible)
    • Review recent medical notes and recent tests
  • IMPRESSIONS:
    • Develop a differential diagnosis
      • ​Actively pursue information and therapy
    • Integrate, synthesise, prioritise and communicate to team
    • Patient issues
  • MANAGEMENT AND DISPOSITION:
    • Management plan for each issue (immediate, short-term, long-term)
    • Logistical plan for further investigation or care
    • Escalate any decision-making, therapeutic or political conflict to senior staff early
    • If ongoing care in ICU needed – coordinate with Intensive Care consultant and ANUM
    • If ongoing care on ward – delegate follow-up roles to treating team members and explicitly handover care to treating team
    • If patient is dying, institute best-practice ward-based palliative care
  • DOCUMENT AND DEBRIEF:
    • Document findings from MET in medical note and MET documentation sticker
    • Debrief team and report difficulties to VHIMs or Intensive Care consultant for follow-up
    • Thank treating team members and return to Intensive Care Unit
    • Allocate ICU liaison nurse or ICU registrar follow-up tasks, if needed