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Papers

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

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7334.387 (Published 16 February 2002) Cite this as: BMJ 2002;324:387

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SURVIVAL FROM CPR INCREASED/

I read with interest the article and hope that before long similar
such MET/OUTREACH studies from the UK will be published. The fact that we
have known for some considerable time that patients who suffer a
"predictable" cardiac arrest is a daily occurrence. Relying on an
"historical training response" from a cardiac arrest team is clearly not
the way to manage critical incidents.
Indeed the NHS is the only service that I am aware of that does not have
dedicated resuscitation experts 24hrs a day. It appears that we have staff
who inherit a bleep at 9am and are asked to attend a collapsed patient at
anytime. This person may not even had any "advance resuscitation skills"
but what is apparent that the CPR team response is critically ill itself
and we need to adopt a more proactive approach.
Training is of paramount importance in recognition of patient
deterioration. Courses such as ILS/ALS/ALERT/APLS etc are of relevance to
all that are concerned with improving survival and dignity in death.
Certainly the early involvement of discussing DNAR will not only reduce
patient, relative and staff anxiety alike but if that means a team with a
different name from the "crash team" undertake this role then so be it.

Competing interests: No competing interests

21 February 2002
Keith Blackie
Senior Resuscitation Officer
Medway Maritime Hospital