Pediatric Medical Emergency Team Events and Outcomes: A Report of 3647 Events From the American Heart Association's Get With the Guidelines-Resuscitation Registry.

TitlePediatric Medical Emergency Team Events and Outcomes: A Report of 3647 Events From the American Heart Association's Get With the Guidelines-Resuscitation Registry.
Publication TypeJournal Article
Year of Publication2016
AuthorsRaymond TT, Bonafide CP, Praestgaard A, Nadkarni VM, Berg RA, Parshuram CS, Hunt EA
Corporate AuthorsAmerican Heart Association Get With the Guidelines-Resuscitation Investigators
JournalHosp Pediatr
Volume6
Issue2
Pagination57-64
Date Published2016 Feb
ISSN2154-1663
KeywordsCardiopulmonary Resuscitation, Child, Preschool, Emergencies, Emergency Medical Services, Emergency Service, Hospital, Female, Guideline Adherence, Heart Arrest, Hospitalization, Hospitals, Pediatric, Humans, Male, Outcome Assessment (Health Care), Practice Guidelines as Topic, Quality Improvement, Registries, Respiratory Insufficiency, United States
Abstract

OBJECTIVES: 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.

DOI10.1542/hpeds.2015-0132
Alternate JournalHosp Pediatr
PubMed ID26813980