Intended for healthcare professionals

Rapid response to:


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: (Published 16 February 2002) Cite this as: BMJ 2002;324:387

Rapid Response:

"Medical Emergency Teams or ICU Nursing Outreach Services?"

Buist et al. describe a reduction in the incidence of and mortality
cardiac arrest following the introduction of a medical emergency team
[1]. Subsequent to the introduction of an ICU nursing outreach team
locally, we observed a reduction in post-ICU hospital mortality from
12.8% to 7.8% (p=0.06, odds ratio 0.62, 95% confidence interval 0.17 -

In contrast to the medical emergency team, the ICU outreach service
provides one experienced ICU nurse on duty each for 12 hours a day,
seven days a week. Although the outreach nurse participates in the
response to emergencies, patients discharged from intensive care are a
primary focus. This high-risk group are reviewed daily until no longer
causing concern.

Both medical emergency teams and ICU nursing outreach services act to
correct physiological deterioration. The mechanisms by which corrective
action is implemented may differ, but the benefits are clear.

Yours sincerely

Julian Millo

specialist registrar

Claire Young

nurse consultant

Jonathan Salmon

consultant physician

John Radcliffe Hospital, Oxford, UK

[1] Buist et al. BMJ 2002;324:1-6

Competing interests: No competing interests

26 February 2002
Julian Millo
Specialist Registrar
Claire Young, Jonathan Salmon
John Radcliffe Hospital