BMJ  2007;335:1210-1212 (8 December), doi:10.1136/bmj.39385.534236.47 (published 29 November 2007)

Practice

Quality Improvement Report

Six year audit of cardiac arrests and medical emergency team calls in an Australian outer metropolitan teaching hospital

¹ Intensive Care Unit, Dandenong Hospital, PO Box 478, Dandenong, VIC 3175, Australia

Abstract

Problem In-hospital cardiac arrest often represents failure of optimal clinical care. The use of medical emergency teams to prevent such events is controversial. In-hospital cardiac arrests have been reduced in several single centre historical control studies, but the only randomised prospective study showed no such benefit. In our hospital an important problem was failure to call the medical emergency team or cardiac arrest team when, before in-hospital cardiac arrest, patients had fulfilled the criteria for calling the team.

Design Single centre, prospective audit of cardiac arrests and data on use of the medical emergency team during 2000 to 2005.

Setting 400 bed general outer suburban metropolitan teaching hospital.

Strategies for change Three initiatives in the hospital to improve use of the medical emergency team: orientation programme for first year doctors, professional development course for medical registrars, and the evolving role of liaison intensive care unit nurses.

Key measures for improvement Incidence of cardiac arrests.

Effects of the change Incidence of cardiac arrests decreased 24% per year, from 2.4/1000 admissions in 2000 to 0.66/1000 admissions in 2005.

Lessons learnt Medical emergency teams can be efficacious when supported with a multidisciplinary, multifaceted education system for clinical staff.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Recognising and responding to acute illness in patients in hospital

Kathryn M Rowan and David A Harrison
BMJ 2007 335: 1165-1166. [Extract] [Full Text] [PDF]

Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study

Michael D Buist, Gaye E Moore, Stephen A Bernard, Bruce P Waxman, Jeremy N Anderson, and Tuan V Nguyen
BMJ 2002 324: 387-390. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Dichtwald, S., Matot, I., Einav, S. (2009). Improving the Outcome of In-Hospital Cardiac Arrest: The Importance of Being EARNEST. SEMIN CARDIOTHORAC VASC ANESTH 13: 19-30 [Abstract]  
• Fowler, R. A., Adhikari, N. K. J., Scales, D. C., Lee, W. L., Rubenfeld, G. D. (2008). Update in Critical Care 2007. Am. J. Respir. Crit. Care Med. 177: 808-819 [Full text]  
• Rowan, K. M, Harrison, D. A (2007). Recognising and responding to acute illness in patients in hospital. BMJ 335: 1165-1166 [Full text]  

Rapid Responses:

Read all Rapid Responses

MET - more information required

Iain D Drummond
bmj.com, 11 Dec 2007 [Full text]

Doing the right thing requires that the right team is called at the right time.

Paul G Lawler
bmj.com, 31 Dec 2007 [Full text]

Online poll

Find out more >>