Yonsei Med J.  2014 Jan;55(1):92-98. 10.3349/ymj.2014.55.1.92.

Does Medical Emergency Team Intervention Reduce the Prevalence of Emergency Endotracheal Intubation Complications?

• Kim GW
• Koh Y
• Lim CM
• Han M
• An J
• Hong SB

• KMID: 1779891
• DOI: http://doi.org/10.3349/ymj.2014.55.1.92

Abstract

PURPOSE
Emergency endotracheal intubation (EEI) is a complex process that leads to various complications. Previous studies mainly demonstrated that the Medical Emergency Team (MET) intervention reduced the incidence of cardiac arrest, however, the impact of a MET on airway management has not been investigated in detail. Our purpose was to confirm the impact of a MET on airway management and compare the incidence of complications of EEI before and after MET intervention in a general ward.
MATERIALS AND METHODS
We performed an observational study and reviewed 318 patients intubated by a MET in a general ward.
RESULTS
The patients enrolled during the control (2007) and study (2009) periods were 103 and 215, respectively. Cardiopulmonary resuscitation requiring emergency intubation in a general ward was reduced after MET intervention at the Asan Medical Center (39.8% vs. 19.1%, p<0.001). Pre-intubation and post-intubation oxygen saturation levels were higher after MET intervention (pre-intubation, 80% before vs. 92% after MET, p<0.001; post-intubation, 95% before vs. 99% after MET, p<0.001). The use of vasopressors after intubation decreased as a result of MET intervention (62.1% before vs. 36.7% after MET, p<0.001). Hypotension was also reduced (34% before vs. 8.8% after MET, p<0.001).
CONCLUSION
Early interventions of a MET changed the causes of emergency intubation in a general ward from cardiopulmonary resuscitation to respiratory distress or shock and improved hypoxemia and hypotension related to emergency intubation. The MET intervention is safe and effective system for emergency intubation in a general ward.

Keyword

Emergency medical service; cardiopulmonary resuscitation; intubation; intratracheal; airway management

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Emergency Medical Services/statistics & numerical data
Female
Humans
Intubation, Intratracheal/*adverse effects
Male
Middle Aged
Prevalence
Young Adult

Figure

• 

  Fig. 1 Reasons for emergency intubation by a MET (*p<0.001). The causes of emergency intubation in a general ward changed from CPR to respiratory distress or shock by early intervention of a MET. The incidence of CPR was reduced, whereas the incidence of respiratory distress or shock increased. MET, Medical Emergency Team; CPR, cardiopulmonary resuscitation.

• 

  Fig. 2 Outcomes before and after MET intervention (*p<0.001). There were no statistically significant differences in outcomes such as complications of intubation and hospital mortality rate. MET, Medical Emergency Team.

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