Medical Emergency Teams

1. Front Matter

   Pages i-xx

   PDF

2. Mets and Patient Safety

   1. Measuring and Improving Safety

      • Peter J. Pronovost, Marlene Miller, Brad Winters, Elizabeth A. Hunt

      Pages 1-17

   2. The Evolution of the Health Care System

      • Kenneth Hillman, Jack Chen, Lis Young

      Pages 18-23

   3. Process Change in Health Care Institutions: Top-Down or Bottom-Up?

      • Lakshmipathi Chelluri

      Pages 24-31

   4. The Challenge of Predicting In-Hospital Iatrogenic Deaths

      • Michael Buist, Donald Campbell

      Pages 32-48

   5. Overview of Hospital Medicine

      • David J. McAdams

      Pages 49-54

   6. Medical Trainees and Patient Safety

      • Stephen W. Lam, Arthas Flabouris

      Pages 55-62

   7. Matching Levels of Care with Levels of Illness

      • Gary B. Smith, Juliane Kause

      Pages 63-79

3. Creating a Mets System

   1. General Principles of Medical Emergency Teams

      • Daryl Jones, Rinaldo Bellomo, Donna Goldsmith

      Pages 80-90

   2. Potential Sociological and Political Barriers to Medical Emergency Team Implementation

      • Michael A. DeVita, Kenneth Hillman

      Pages 91-103

   3. Overview of Various Medical Emergency Team Models

      • Michelle Cretikos, Rinaldo Bellomo

      Pages 104-115

   4. Early Goal-Directed Therapy

      • David T. Huang, Scott R. Gunn, Emanuel P. Rivers

      Pages 116-121

   5. Nurse-Led Medical Emergency Teams: A Recipe for Success in Community Hospitals

      • Kathy D. Duncan

      Pages 122-133

   6. ICU Without Walls: A New York City Model

      • Vladimir Kvetan, Brian Currie

      Pages 134-144

   7. Hospital Size and Location and the Feasibility of the Medical Emergency Team

      • Daryl Jones, Rinaldo Bellomo

      Pages 145-151

   8. Medical Emergency Teams in Teaching Hospitals

      • Helen Ingrid Opdam

      Pages 152-162

   9. The Nurse’s Perspective

      • Nicolette C. Mininni, Carole C. Scholle

      Pages 163-172

   10. The Hospital Administrator’s Perspective

       • Craig White, Rinaldo Bellomo

       Pages 173-183

   11. Personnel Resources for Crisis Response

       • Andrew W. Murray, Michael A. DeVita, John J. Schaefer III

       Pages 184-198

   12. Equipment, Medications, and Supplies for a Medical Emergency Team Response

       • Edgar Delgado, Wendeline J. Grbach, Joanne Kowiatek, Michael A. DeVita

       Pages 199-216

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

• MET
• RRS
• care
• crisis response
• critical care
• medical emergency team
• patient safety
• rapid response system

From the reviews:

"The aim of this book is to provide a manual describing the approach to creating a Medical Emergency Team (MET) service and evaluating its performance. The book presents a comprehensive overview of the concept … . Examples from practice are frequently cited from a global perspective. … Chapters are self-sufficient units that each review one aspect of the MET. … it is an important guide to the dos and don’ts of establishing a MET." (Ann McGinley and Rupert M Pearse, Critical Care Forum, April, 2007)

"The medical emergency team (MET) is a concept which is aimed at identifying those hospital patients at risk of clinical deterioration. … This book aims to be a guide to health care professionals and administrators wishing to implement this concept in their hospital. It is intended primarily as a resource for those aiming to set up a MET in their hospital. … It should certainly be read by hospital administrators and those interested in quality improvement, currently working in hospitals without such teams." (L. Walker and N. R. Webster, British Journal of Anaesthesia, Vol. 97 (6), 2006)

"A comprehensive multiauthored review that examines techniques for implementation and assessment of hospital-based medical emergency teams (METs). … This readable text provides great background and advice for anyone involved in implementation of a MET. … All physicians actively involved in a hospital-based practice. In addition, nurses, respiratory therapists, and hospital administrators actively involved in MET implementation will find … useful." (Nicola Schiebel, Mayo Clinic Proceedings, Vol. 81 (7), July, 2006)

• University of Pittsburgh School of Medicine, Pittsburgh, USA

  Michael A. DeVita

• UPMC Presbyterian Hospital, Pittsburgh, USA

  Michael A. DeVita

• The Simpson Centre for Health Services Research, Liverpool Hospital, Liverpool, Australia

  Kenneth Hillman

• Austin Hospital, Heidelberg, Australia

  Rinaldo Bellomo

Policies and ethics