The Critical Care track of the Society for Emergency Medicine in Singapore Annual Scientific Meeting 2014.
For more information and conference videos, go to singem.blogspot.sg
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SEMS 2014: Augustine Tee - Inpatient Medical Emergency Teams
1.
2. How prevalent are cardiac arrests?
As high as 35% of all adult in-hospital
cardiac arrests happen in general
wards. (45% ICU, 11% A&E)
From the National registry of CPR (US & Canada), 253 hospitals, 2000 – 2004.
Nadkarni et al. JAMA 2006; 295: 50-57
3. 1/3 of in-hospital cardiac arrests & subsequent
attempts to resuscitate could have been
prevented
• patient assessment deficient – 47%
• warning signs of deteriorating – 75%
• warning signs not recognised – 35%
• not acted on – 56%
• not communicated to senior doctors – 55%
• lack of input from senior clinicians in the 48-hours prior
to cardiac arrest.
National Confidential Enquiry into Patient Outcome and Death (NCEPOD) 2012
4.
5. Unplanned ICU admissions have higher hospital
mortality
Planned Unplanned
Group
0
100
200
300
400
Count
Mortality
Yes
No
story
Origin of MET
Eg of early intervention – STEMI, cva, trauma golden hr, egdt
Inpatient code blue
Types of failure
Types of RRS
Structure of RRS
Merit study & evidence
MEWS?
CGH experience
Video?
The future: nurse-led RRT
Closing story