Overview

Detection and response to patient deterioration is part of the National Safety and Quality Health Service Standards and requires a hospital-wide agreed response. The Medical Emergency Team (MET) at Bendigo is a form of Rapid Response Team (RRT) which is supported by the Intensive Care Unit. The MET supports ward staff in managing and extending care at the bedside of a deteriorating patent. Code Blue teams respond to deteriorated patients with immediately life-threatening problems.

MET teams have evolved from the need to pre-empt and avert cardiorespiratory arrest, and to divert inappropriate admissions to the Intensive Care Department. A review of MET system progress and development may be found in the referenced articles below. Patients undergoing MET calls have approximately five times the in-hospital mortality of patients without a MET call (10% vs 1.8%). MET calls have coincided with a reduction of cardiac arrest calls (Bendigo (2002 vs 2015) 3 per 1000 admits v < 1 per 1000 admits).

• Overview
• ​MET call team behaviour
• MET call team set-up
• Your role in a MET call team
  
• Team communication 
• Types of problems seen on MET calls
• ​A framework for approaching a MET call as an ICU registrar

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References:
1. Jones, D., et al., Medical emergency team syndromes and an approach to their management. Crit Care, 2006. 10(1): p. R30.
2. Gillon, S., et al., Crisis resource management, simulation training and the medical emergency team. Crit Care Resusc, 2012. 14: p. 227-235.
3. Jones, D.A., N.J. Dunbar, and R. Bellomo, Clinical deterioration in hospital inpatients: the need for another paradigm shift. The Medical Journal of Australia, 2012.196(2): p. 97-100.
4. Investigators, A.-C.M.d., et al., Rapid Response Team composition, resourcing and calling criteria in Australia. Resuscitation, 2012. 83(5): p. 563-7.
5. Jones, D., et al., The rapid response system and end-of-life care. Curr Opin Crit Care, 2013. 19(6): p. 616-23.
6. Jones, D., et al., Defining clinical deterioration. Resuscitation, 2013. 84(8): p. 1029-34.
7. Rozen, T.H., et al., Antecedents to cardiac arrests in a teaching hospital intensive care unit. Resuscitation, 2014. 85(3): p. 411-7.
8. Topple, M., et al., Features of an Intensive Care based Medical Emergency Team nurse training program in a University Teaching Hospital. Aust Crit Care, 2015.
9. Austin Health, M.E.T.n.i., et al., Tasks completed by nursing members of a teaching hospital Medical Emergency Team. Intensive Crit Care Nurs, 2016. 32: p. 12-9.
10. Pedersen, A., A. Psirides, and M. Coombs, Models and activities of critical care outreach in New Zealand hospitals: results of a national census. Nurs Crit Care, 2014.
11. Jones, D., R. Bellomo, and M.A. DeVita, Effectiveness of the Medical Emergency Team: the importance of dose. Crit Care, 2009. 13(5): p. 313.