From the Guidelines
A standard clinical template for a Medical Emergency Team (MET) call assessment should include patient identifiers, vital signs, level of consciousness, reason for MET activation, brief relevant history, current medications, allergies, and recent interventions, as well as documentation of interventions and a clear assessment of the patient's condition, working diagnosis, and plan of action, as recommended by the most recent guidelines 1. The template should document physical examination findings focusing on airway, breathing, circulation, disability, and exposure (ABCDE approach), including:
- Vital signs: heart rate, blood pressure, respiratory rate, oxygen saturation, temperature
- Level of consciousness: using the AVPU scale or Glasgow Coma Scale
- Reason for MET activation: including primary reason and specific activation criteria
- Brief relevant history: including current medications, allergies, and recent interventions
- Laboratory values and point-of-care testing results
- Relevant imaging findings The template should also provide space to document interventions performed during the MET response, including:
- Medications administered with doses and times
- Oxygen therapy
- Fluid resuscitation
- Any procedures, such as those listed in Table 8 of the Utstein-style scientific statement 1, including non-medication therapy, medication therapy, and treatment limitation initiated A clear assessment of the patient's condition, working diagnosis, and plan of action should be documented, including disposition decisions, such as ICU transfer or continued monitoring, and timestamps for MET activation, arrival, and key interventions to track response times, as suggested by the guidelines for monitoring and reporting MET activations 1. Using a standardized template ensures comprehensive assessment during high-stress situations, promotes clear communication between team members, establishes documentation for continuity of care, and facilitates quality improvement reviews of MET activations, ultimately prioritizing morbidity, mortality, and quality of life as the outcome.
From the Research
Standard Clinical Template for Assessment during a Medical Emergency Team (MET) Call
The following elements should be included in a standard clinical template for assessment during a MET call:
- Patient identification and location
- Reason for the MET call, including:
- Current vital signs, including:
- Respiratory rate and oxygen saturation
- Heart rate and blood pressure
- Level of consciousness and neurological status
- Relevant medical history and current diagnoses
- Current treatments and medications, including:
- Assessment of the patient's airway, breathing, and circulation (ABCs)
- Neurological assessment, including level of consciousness and neurological deficits
- Documentation of the patient's response to interventions and any changes in their condition
Key Principles of Vital Signs Assessment
The assessment of vital signs is critical for safe, high-quality care, and should include:
- Regular monitoring of vital signs, including respiratory rate, heart rate, blood pressure, and oxygen saturation 5
- Documentation of any abnormalities or changes in vital signs
- Use of vital signs data to inform clinical decision-making and guide treatment
Considerations for MET Call Documentation
Documentation of MET calls should include:
- Clear and concise information about the reason for the call and the patient's condition
- Accurate and complete vital sign data
- Documentation of any interventions or treatments provided during the MET call
- Communication with the patient's healthcare team and family members, as appropriate