tailieunhanh - Báo cáo y học: "Effectiveness of the Medical Emergency Team: the importance of dos"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Effectiveness of the Medical Emergency Team: the importance of dose. | Available online http content 13 5 313 Viewpoint Effectiveness of the Medical Emergency Team the importance of dose Daryl Jones1 Rinaldo Bellomo1 and Michael A DeVita2 1 Department of Intensive Care Austin Hospital Studley Road Heidelberg VIC 3084 Australia 2West Penn Allegheny Health System Pittsburgh PA USA Corresponding author Daryl Jones Published 6 October 2009 This article is online at http content 13 5 313 2009 BioMed Central Ltd Critical Care 2009 13 313 doi cc7996 Abstract Up to 17 of hospital admissions are complicated by serious adverse events unrelated to the patients presenting medical condition. Rapid Response Teams RRTs review patients during early phase of deterioration to reduce patient morbidity and mortality. However reports of the efficacy of these teams are varied. The aims of this article were to explore the concept of RRT dose to assess whether RRT dose improves patient outcomes and to assess whether there is evidence that inclusion of a physician in the team impacts on the effectiveness of the team. A review of available literature suggested that the method of reporting RRT utilization rate RRT dose is calls per 1 000 admissions. Hospitals with mature RRTs that report improved patient outcome following RRT introduction have a RRT dose between and calls per 1 000 admissions. Four studies report an association between increasing RRT dose and reduced in-hospital cardiac arrest rates. Another reported that increasing RRT dose reduced in-hospital mortality for surgical but not medical patients. The MERIT study investigators reported a negative relationship between MET-like activity and the incidence of serious adverse events. Fourteen studies reported improved patient outcome in association with the introduction of a RRT and 13 14 involved a Physician-led MET. These findings suggest that if the RRT is the major method for reviewing serious adverse events the dose of RRT .