From the Research
When responding to a Medical Emergency Team (MET) call, the initial steps involve a systematic approach to rapidly assess and stabilize the patient using the ABCDE approach, as this structured method ensures no critical elements are missed during the high-stress initial minutes of emergency response, which can significantly impact patient outcomes. The ABCDE approach, which stands for Airway, Breathing, Circulation, Disability, and Exposure, is widely accepted by experts in emergency medicine and is applicable in all clinical emergencies for immediate assessment and treatment 1.
Initial Assessment
The first step is to introduce yourself to the team and identify your role while quickly obtaining a brief handover from the primary nurse or physician about the patient's condition and reason for the MET activation. Immediately assess the patient using the ABCDE approach:
- Airway: ensure it's patent
- Breathing: check respiratory rate, oxygen saturation, and work of breathing
- Circulation: assess pulse, blood pressure, capillary refill
- Disability: check consciousness level using AVPU or GCS
- Exposure: examine for rashes, bleeding, or other visible abnormalities
Efficient Care Delivery
Simultaneously, request vital signs, recent lab results, and relevant medical history including allergies and current medications. Assign specific roles to team members to ensure efficient care delivery, with clear tasks for:
- Obtaining IV access
- Cardiac monitoring
- Medication preparation
- Documentation
Immediate Interventions
Order immediate interventions based on your assessment findings, such as:
- Oxygen therapy (starting at 15L via non-rebreather mask for severe distress)
- IV fluid boluses (typically 500ml-1L of crystalloid for hypotension)
- Specific medications as indicated by the patient's condition, such as intramuscular epinephrine for anaphylaxis 2 or push-dose vasopressin for hypotension in septic shock 3
This approach is supported by various studies, including one that analyzed medical emergency team calls comparing subjective to "objective" call criteria, which found that the "worried" criterion was the most frequent reason for MET calls, often related to problems with Airway, Breathing, Circulation, or Neurology 4. Another study emphasized the importance of respiratory assessment in critically ill patients, highlighting the need for comprehensive assessment to identify problems early and initiate specific interventions 5.