Types of problems seen on MET calls

MET calls can be triggered by standardised MET criteria for all patients. Criteria for MET activation include ‘staff worried’ which enables a staff member to gain help when not certain about ongoing state of the patient or resources needed to manage the patient.  Different scenarios may present themselves, as suggested in previous papers (Jones D, 2006). Scenarios represented commonly at Bendigo Hospital include:

1. Decision-making about a dying patient (End-of-Life-Care MET call)

• Approximately 1/3 of MET calls
• MET calls can be a period to consider the healthcare trajectory of the deteriorating patient
• MET calls are a trigger point for further documentation of goals of care and limits on resuscitation and care escalation
• Managing acute palliation may be part of this type of MET call
  • Catastrophic haemorrhage
  • Severe terminal agitation
  • Uncontrolled pain or terminal symptoms

2. Undifferentiated patient with organ dysfunction

• 1 organ dysfunction
• 2 organ dysfunction
• 3 organ dysfunction

3. Common scenarios

• Altered conscious state or cognition
• Cardiovascular failure
• Respiratory failure
• Sepsis
• Escalation of an Urgent Clinical Review (UCR)

• 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