title: Pediatric Medical Emergency Team Events and Outcomes: A Report of 3647 Events From the American Heart Association's Get With the Guidelines-Resuscitation Registry.
abstract: OBJECTIVE
  To describe the clinical characteristics and outcomes of a large, multicenter cohort of pediatric medical emergency team (MET) events occurring in US hospitals reported to the American Heart Association's Get With the Guidelines-Resuscitation registry.
  
  
  METHODS
  We analyzed consecutive pediatric (<18 years) MET events reported to the registry from January 2006 to February 2012.
  
  
  RESULTS
  We identified 3647 MET events from 151 US hospitals: 3080 (84%) ward and 567 (16%) telemetry/step-down unit events; median age 3.0 years (interquartile range: 0.0-11.0); 54% male; median duration 29 minutes (interquartile range: 18-49). Triggers included decreased oxygen saturation (32%), difficulty breathing (26%), and staff concern (24%). Thirty-seven percent (1137/3059) were admitted within 24 hours before MET event. Within 24 hours before the MET event, 16% were transferred from a PICU, 24% from an emergency department, and 7% from a pediatric anesthesia care unit. Fifty-three percent of MET events resulted in transfer to a PICU; 3251 (89%) received nonpharmacologic interventions, 2135 (59%) received pharmacologic interventions, 223 (6.1%) progressed to an acute respiratory compromise event, and 17 events (0.5%) escalated to cardiopulmonary arrest during the event. Survival to hospital discharge was 93.3% (n=3299/3536).
  
  
  CONCLUSIONS
  Few pediatric MET events progress to respiratory or cardiac arrest, but most require nonpharmacologic and pharmacologic intervention. Median duration of MET event was 29 minutes (interquartile range: 18-49), and 53% required transfer to a PICU. Events often occurred within 24 hours after hospital admission or transfer from the PICU, emergency department, or pediatric anesthesia care unit and may represent an opportunity to improve triage and other systems of care.
authors.affiliation: Department of Pediatrics and Critical Care Medicine, Section of Pediatric Cardiac Intensive Care, Medical City Children's Hospital, Dallas, Texas; tiaraymond@me.com.
authors.forename: Tia T
authors.initials: TT
authors.lastname: Raymond
authors.affiliation: Departments of Pediatrics.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Bonafide
authors.affiliation: Department of Biostatistics, The University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Amy
authors.initials: A
authors.lastname: Praestgaard
authors.affiliation: Anesthesiology, Critical Care Medicine, and Pediatrics, and.
authors.forename: Vinay M
authors.initials: VM
authors.lastname: Nadkarni
authors.affiliation: Departments of Pediatrics, Critical Care Medicine, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.affiliation: Department of Critical Care Medicine, Hospital for Sick Children, University of Toronto, Toronto, Canada; Department of Paediatrics and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; and.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parshuram
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hunt
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards; D002675:Child, Preschool; D004630:Emergencies / Q000145:classification / Q000453:epidemiology; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012042:Registries; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D014481:United States / Q000453:epidemiology
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