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


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


METHODS
400 bed general outer suburban metropolitan teaching hospital.


METHODS
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.


METHODS
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.


CONCLUSIONS
Medical emergency teams can be efficacious when supported with a multidisciplinary, multifaceted education system for clinical staff.
Intensive Care Unit, Dandenong Hospital, PO Box 478, Dandenong, VIC 3175, Australia. mbuist@patientrack.com
Michael
M
Buist
Julia
J
Harrison
Ellie
E
Abaloz
Susan
S
Van Dyke
D004635:Emergency Medicine / Q000193:education; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D004638:Emergency Treatment / Q000706:statistics & numerical data / Q000639:trends; D006323:Heart Arrest / Q000628:therapy*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data* / Q000639:trends; D006786:Hospitals, Urban / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000193:education; D010348:Patient Care Team; D011446:Prospective Studies; D011787:Quality of Health Care; D013192:Staff Development; D014739:Victoria