A prospective before‐and‐after trial of a medical emergency team

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Abstract
Objective: To determine the effect on cardiac arrests and overall hospital mortality of an intensive care‐based medical emergency team. Design and setting: Prospective before‐and‐after trial in a tertiary referral hospital. Patients: Consecutive patients admitted to hospital during a 4‐month “before” period (May–August 1999) (n = 21 090) and a 4‐month intervention period (November 2000 –February 2001) (n = 20 921). Main outcome measures: Number of cardiac arrests, number of patients dying after cardiac arrest, number of postcardiac‐arrest bed‐days and overall number of in‐hospital deaths. Results: There were 63 cardiac arrests in the “before” period and 22 in the intervention period (relative risk reduction, RRR: 65%; P < 0.001). Thirty‐seven deaths were attributed to cardiac arrests in the “before” period and 16 in the intervention period (RRR: 56%; P = 0.005). Survivors of cardiac arrest in the “before” period required 163 ICU bed‐days versus 33 in the intervention period (RRR: 80%; P < 0.001), and 1353 hospital bed‐days versus 159 in the intervention period (RRR: 88%; P < 0.001). There were 302 deaths in the “before” period and 222 in the intervention period (RRR: 26%; P = 0.004). Conclusions: The incidence of in‐hospital cardiac arrest and death following cardiac arrest, bed occupancy related to cardiac arrest, and overall in‐hospital mortality decreased after introducing an intensive care‐based medical emergency team.