An Observational Analysis of Medication Use During 5,727 Medical Emergency Team Activations at a Tertiary Referral Hospital

摘要

Background: Medical emergency teams (METs) rescue deteriorating patients as the response arm of hospital rapid responsesystems. This study aimed to (1) investigate medication use during MET activations by describing the type, frequency and accesssources of medications; and (2) assess associations between patient characteristics, MET activation criteria, and outcomesand MET medication use.Methods: A single-center, retrospective study from a prospective database of MET activations in an Australian tertiary referralhospital was undertaken. Consecutive adult MET activations over a 12-month period were included.Results: Across the study period, there were 5,727 MET activations with medications used at 33.5% (n = 1,920). Of 2,648medications used, cardiac system agents (n = 944; 35.6%) were the most common category used, while intravenous electrolytes(n = 341; 12.9%) and opioid analgesics (n = 248; 9.4%).were the most frequently used medications. Most commonly, medicationswere sourced from ward stocks. High blood pressure, heart or respiratory rate, pain, and multiple activation criteria wereassociated with MET medication use (p < 0.001). Patients who required medications were less likely to remain on the ward, andimmediate admission to the ICU was approximately doubled (odds ratio = 1.90; 95% confidence interval = 1.47–2.45).Conclusion: Medication use by theMET was common and associated with escalation to intensive care. A wide variety of medications,principally from ward stocks, were used with some predictability based on activation criteria. Local system improvementshave demonstrated that by focusing on common MET syndromes and medications, further investigation can refineand improve medication use and management systems for deteriorating patients.