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le='font-style: italic'>Objectivo: Descrever as razões para a activação de uma Equipa de Emergência Médica (EEM). le='font-style: italic'>Métodos: Análise retrospectiva das chamadas da EEM em 1998. le='font-style: italic'>Resultados: Houve 713 chamadas para 599 doentes internados. Dos 599 pacientes, 252 (45 % ) foram admitidos na UCI (Unidade de Cuidados Intensivos) e 49 (6.9 % ) morreram durante a resposta da EEM. Os três motivos mais comuns para activar a EEM foram diminuição na ECG (Escala de Coma de Glasgow) >2 (n=155); pressão arterial sistólica < 90 mmHg (n=142) e frequência respiratória > 35 (n=109). 61 das chamadas foram por paragem cardíaca e tiveram uma mortalidade imediata de 59 % . O critério que mais vezes se associou a internamento na UCI foi uma frequência respiratória >35. Quando as chamadas da EEM foram ditadas apenas nos critérios de ‘preocupação’ só 16 % dos doentes foram admitidos na UCI. A EEM sentiu que a Ordem de Não Reanimar (DNR) teria sido apropriada em 130 casos (22 % ). Existiam ordens DNR foram documentadas em 27 das chamadas da EEM. le='font-style: italic'>Conclusão: O sistema EEM define critérios objectivos e subjectivos através dos quais a equipa médica e de enfermagem podem identificar doentes agudizados. Uma proporção elevada destes doentes requerer admissão em Cuidados Intensivos. O sistema da EEM permite identificar doentes para quem a ordem DNR deve ser considerada.

le&_coverDate=07 % 2F31 % 2F2001&_sk=999499998&view=c&wchp=dGLzVzz-zSkWW&md5=b944d4e11ec93606e6f983be7a5ae8ef&ie=/sdarticle.pdf"" target=""newPdfWin"" onClick=""var newWidth=((document.body.clientWidth*90)/100); var newHeight=document.body.clientHeight; var pdfWin; pdfWin=window.open('','newPdfWin','width='+newWidth+',height='+newHeight+',resizable=yes, left=50, top=50');pdfWin.focus()"">le=""vertical-align:absmiddle;"" border=""0"" src=""http://www.sciencedirect.com/scidirimg/icon_pdf.gif"" alt=""""> PDF (226 K)le>
lass=""infobubble-container"">
lass=""mlktLink"" id=""mlktLink_3"">le cellpadding=0 cellspacing=0 border=0>lign=""top"" style=""padding: 5px 5px 0px 5px"">llet_square.gif"" alt="""">leURL&_udi=B7590-4S9R86M-2&_user=2795313&_origUdi=B6T19-4RR215W-2&_fmt=high&_coverDate=04 % 2F18 % 2F2008&_rdoc=1&_orig=article&_acct=C000058823&_version=1&_urlVersion=0&_userid=2795313&md5=004188aa623ae55e0ff3cac98db964b6"" onMouseOver=""InfoBubble.show('infobubble_3','mlktLink_3')"" onMouseOut=""InfoBubble.timeout()"">Characteristics and outcomes of patients receiving a me...
Journal of Critical Care

le>
lass=""infobubble"" id=""infobubble_3"" onMouseOver=""InfoBubble.show('infobubble_3','mlktLink_3')"" onMouseOut=""InfoBubble.timeout()"">le cellpadding=0 cellspacing=0 width=100 % >
le=""float:right; padding-left:5px"">lick=""InfoBubble.hide()"">lose.gif"" alt=""Close"" title=""Close"" onmouseover=""javascript:this.src='/scidirimg/btn_xclose_hov.gif';"" onmouseout=""javascript:this.src='/scidirimg/btn_xclose.gif';"">
lt=""You are entitled to access the full text of this document"" title=""You are entitled to access the full text of this document"" width=12 height=14""> leURL&_udi=B7590-4S9R86M-2&_user=2795313&_coverDate=04 % 2F18 % 2F2008&_rdoc=1&_fmt=high&_orig=article&_cdi=12940&_sort=v&_docanchor=&view=c&_ct=36&_acct=C000058823&_version=1&_urlVersion=0&_userid=2795313&md5=ec8ec9c6d1e78f44f3279ded8cee9865"">Characteristics and outcomes of patients receiving a medical emergency team review for respiratory distress or hypotension
Journal of Critical Carelor=""#FF0000"">In Press, Corrected ProofAvailable online 18 April 2008
Jon L. Quach, Andrew W. Downey, Michael Haase, Anja Haase-Fielitz, Daryl Jones, Rinaldo Bellomo

Abstract
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le=""line-height:150 % "">

lass=""h4"">Purpose

To describe the characteristics and outcomes of patients receiving a medical emergency team (MET) review for the MET syndromes of respiratory distress or hypotension and to assess the effect of delayed MET activation on their outcomes.

lass=""h4"">Materials and Methods

We retrospectively analyzed the medical records of 2 cohorts of 100 patients for each of the MET syndromes of respiratory distress and hypotension. We collected information on patient demographics, comorbidities, presence of sepsis, and patient outcome. We documented the presence and duration of delayed MET activation.

lass=""h4"">Results

Patients with respiratory distress were more likely to be postoperative (40 % vs 28 % , le='font-style: italic'>P = .07), but less likely to have a history of congestive cardiac failure (12 % vs 22 % , le='font-style: italic'>P = .06). Sepsis was present in 58 % of cases. The hospital mortality for MET calls due to respiratory distress and hypotension was 38 % and 35 % , respectively (le='font-style: italic'>P = .77). Delayed MET calls occurred in 50 % of patients with the MET syndrome of respiratory distress and in 39 % of those with hypotension (le='font-style: italic'>P = .11). The median duration of delay was 12 hours in patients with respiratory distress compared to 5 hours for patients with hypotension (le='font-style: italic'>P = .016). A delay in making a MET call was associated with an increase in mortality (odds ratio, 2.10; 95 % confidence interval, 1.01-4.34; le='font-style: italic'>P = .045).

lass=""h4"">Conclusions

Patients receiving MET calls for respiratory distress or hypotension were elderly and had a mortality greater than 35 % . In many cases, MET activation was delayed. This delay was associated with increased mortality.


le&_coverDate=04 % 2F18 % 2F2008&_sk=999999999&view=c&wchp=dGLzVzz-zSkWW&md5=72b64a9fc259b6bebe581ec765f6d778&ie=/sdarticle.pdf"" target=""newPdfWin"" onClick=""var newWidth=((document.body.clientWidth*90)/100); var newHeight=document.body.clientHeight; var pdfWin; pdfWin=window.open('','newPdfWin','width='+newWidth+',height='+newHeight+',resizable=yes, left=50, top=50');pdfWin.focus()"">le=""vertical-align:absmiddle;"" border=""0"" src=""http://www.sciencedirect.com/scidirimg/icon_pdf.gif"" alt=""""> PDF (216 K)
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Copyright © 2008 Elsevier Ireland Ltd All rights reserved.

lass=""h4"">Clinical paper

lass=""articleTitle"">

The Medical Emergency Team system: A two hospital comparisonlt=""star, open"" title=""star, open"" border=""0"">

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