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Reduction of unexpected serious adverse events after introducing medical emergency team

机译:引入医疗急救队后减少意外的严重不良事件

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Aim To assess the clinical benefits of introducing a medical emergency team system for early medical intervention in hospital care. Methods This prospective analysis included all cases of medical emergency team activation during the first year after the introduction of the medical emergency team system at C hiba U niversity H ospital ( C hiba, J apan) in F ebruary 2011. The rates of in‐hospital mortality and unexpected events before and after introduction of the medical emergency team system were compared. Results The total number of medical emergency team activation calls was 83 (4.9 per 1,000 admissions). The activation of the medical emergency team system was requested most frequently from the general ward (56.6%) and by a physician (57.8%), with the most important reasons for activation being cardiac arrest (37.3%), breathing abnormality (33.7%), and impaired consciousness (32.5%). The most frequent medical interventions by the medical emergency team were intubation (43.3%) and oxygen inhalation (41.0%). Approximately one‐half of the patients requiring activation of the medical emergency team system were critically ill and needed subsequent intensive care unit admission. Although no significant difference was observed between the pre‐ and post‐ medical emergency team in‐hospital mortalities (2.1% versus 2.0%, respectively), the incidence rate of serious events significantly decreased (12.4% versus 6.8%, respectively; P ?=?0.015). Conclusion Most patients requiring activation of the medical emergency team system were critically ill and needed emergency treatment at the location of the medical emergency team activation, with subsequent critical care. Although the introduction of the medical emergency team system did not affect the in‐hospital mortality rate, it reduced the incidence of unexpected serious adverse events, suggesting that it may be clinically useful.
机译:目的评估在医院护理中引入医疗急救队系统以进行早期医学干预的临床收益。方法这项前瞻性分析包括2011年2月在芝巴大学医院(芝巴,日本)引入医疗急救队系统后第一年内所有医疗急救队激活的案例。住院率比较了引入医疗急救队系统之前和之后的死亡率和意外事件。结果急诊医疗队的激活电话总数为83(每1,000招生中有4.9个)。一般科室(56.6%)和医生(57.8%)经常要求激活医疗急诊小组系统,最重要的激活原因是心脏骤停(37.3%),呼吸异常(33.7%) ,以及意识受损(32.5%)。紧急医疗队最常进行的医疗干预是插管(43.3%)和吸氧(41.0%)。需要激活医疗急救队系统的患者中约有一半患有重病,需要随后接受重症监护病房。尽管在医疗急救队的住院前后死亡率没有显着差异(分别为2.1%和2.0%),但严重事件的发生率却显着降低(分别为12.4%和6.8%; P≥0.015)。结论大多数需要激活医疗急救团队系统的患者危重病,需要在医疗急救团队激活的地点进行紧急治疗,并进行重症监护。尽管引入医疗急救队系统并没有影响院内死亡率,但它降低了意料之外的严重不良事件的发生率,这表明它可能在临床上有用。

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