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

American Heart Association Get With The Guidelines-Resuscitation Investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)57-64
Number of pages8
JournalHospital Pediatrics
Volume6
Issue number2
DOIs
StatePublished - Feb 1 2016

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American Heart Association
Resuscitation
Registries
Emergencies
Guidelines
Pediatrics
Heart Arrest
Hospital Emergency Service
Anesthesia
Telemetry
Triage
Respiration
Oxygen

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics

Cite this

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

In: Hospital Pediatrics, Vol. 6, No. 2, 01.02.2016, p. 57-64.

Research output: Contribution to journalArticle

American Heart Association Get With The Guidelines-Resuscitation Investigators. / Pediatric Medical Emergency Team Events and Outcomes : A Report of 3647 Events From the American Heart Association's Get With the Guidelines-Resuscitation Registry. In: Hospital Pediatrics. 2016 ; Vol. 6, No. 2. pp. 57-64.
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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.",
author = "{American Heart Association Get With The Guidelines-Resuscitation Investigators} and Raymond, {Tia T.} and Bonafide, {Christopher P.} and Amy Praestgaard and Nadkarni, {Vinay M.} and Berg, {Robert A.} and Parshuram, {Christopher S.} and Elizabeth Hunt",
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AB - 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.

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