title: Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study.
abstract: OBJECTIVE
  To determine whether earlier clinical intervention by a medical emergency team prompted by clinical instability in a patient could reduce the incidence of and mortality from unexpected cardiac arrest in hospital.
  
  
  METHODS
  A non-randomised, population based study before (1996) and after (1999) introduction of the medical emergency team.
  
  
  METHODS
  300 bed tertiary referral teaching hospital.
  
  
  METHODS
  All patients admitted to the hospital in 1996 (n=19 317) and 1999 (n=22 847).
  
  
  METHODS
  Medical emergency team (two doctors and one senior intensive care nurse) attended clinically unstable patients immediately with resuscitation drugs, fluid, and equipment. Response activated by the bedside nurse or doctor according to predefined criteria.
  
  
  METHODS
  Incidence and outcome of unexpected cardiac arrest.
  
  
  RESULTS
  The incidence of unexpected cardiac arrest was 3.77 per 1000 hospital admissions (73 cases) in 1996 (before intervention) and 2.05 per 1000 admissions (47 cases) in 1999 (after intervention), with mortality being 77% (56 patients) and 55% (26 patients), respectively. After adjustment for case mix the intervention was associated with a 50% reduction in the incidence of unexpected cardiac arrest (odds ratio 0.50, 95% confidence interval 0.35 to 0.73).
  
  
  CONCLUSIONS
  In clinically unstable inpatients early intervention by a medical emergency team significantly reduces the incidence of and mortality from unexpected cardiac arrest in hospital.
authors.affiliation: Department of Intensive Care, Dandenong Hospital, Dandenong, VIC 3175, Australia. acmdbuist@bigpond.com
authors.forename: Michael D
authors.initials: MD
authors.lastname: Buist
authors.forename: Gaye E
authors.initials: GE
authors.lastname: Moore
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Bernard
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Waxman
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Anderson
authors.forename: Tuan V
authors.initials: TV
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000517:prevention & control*; D006745:Hospital Bed Capacity, 300 to 499; D017052:Hospital Mortality / Q000639:trends*; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010348:Patient Care Team / Q000458:organization & administration*; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology