MET and Code Blue

Medical Emergency Team (MET) Call Criteria and Definition

The Medical Emergency Team (MET) protocol is a critical care response system designed to identify and treat patients who show early signs of clinical deterioration. Activation of a MET call is based on specific physiological thresholds across various body systems.

  • General Response Criterion

    • The protocol explicitly states that a MET call should be initiated if you are worried about a patient's clinical status, regardless of whether they meet the specific physiological criteria below.

  • Temperature Parameters

    • Hypothermia threshold: Temperature ≤35 ∘C\le 35\,^{\circ}\text{C}.

    • Hyperpyrexia threshold: Temperature ≥40 ∘C\ge 40\,^{\circ}\text{C}.

  • Cardiovascular Criteria

    • Systolic Blood Pressure (SBP): Triggered when SBP is outside the range of 90−200 mmHg90-200\,\text{mmHg} (<90 mmHg< 90\,\text{mmHg} or >200 mmHg> 200\,\text{mmHg}).

    • Acute Hypotensive Change: A fall in SBP of >20−40 mmHg> 20-40\,\text{mmHg} that is not caused by the administration of medications.

    • Heart Rate (HR): Triggered if HR is <40 beats min−1< 40\,\text{beats}\,\text{min}^{-1} or >130 beats min−1> 130\,\text{beats}\,\text{min}^{-1}.

    • Clinical Presentation:

      • The presence of uncontrolled bleeding.

      • The presence of uncontrolled chest pain.

  • Respiratory Criteria

    • Respiratory Rate (RR): Thresholds are set at 88 and 28 breaths min−128\,\text{breaths}\,\text{min}^{-1}.

    • Oxygen Saturation (SaO2SaO_2): An MET call is required if SaO2<90%SaO_2 < 90\% while the patient is receiving 6 dm36\,\text{dm}^3 of O2O_2 via a Hudson mask.

    • Airway and Breathing Effort:

      • Presence of stridor (indicative of upper airway obstruction).

      • Signs of severe breathing difficulties.

  • Neurological Criteria

    • Any detectable decreased conscious state.

    • Presence of uncontrolled pain.

    • Occurrence of seizures.

  • Renal Criteria (Urine Output)

    • Oliguria: Urine output measured at <150 cm3< 150\,\text{cm}^3 within a period of 6 hours6\,\text{hours}.

    • Polyuria: Urine output measured at >500 cm3> 500\,\text{cm}^3 within a duration of 1 hour1\,\text{hour}.

  • Endocrine Criteria

    • Blood Glucose Levels: Triggered if levels are <3 mmol dm−3< 3\,\text{mmol}\,\text{dm}^{-3} or >20 mmol dm−3> 20\,\text{mmol}\,\text{dm}^{-3}.

  • Laboratory Criteria

    • Sodium (NaNa): Triggered if levels are <125 mmol dm−3< 125\,\text{mmol}\,\text{dm}^{-3} or >155 mmol dm−3> 155\,\text{mmol}\,\text{dm}^{-3}.

    • Potassium (KK): Triggered if levels are <3 mmol dm−3< 3\,\text{mmol}\,\text{dm}^{-3} or >6 mmol dm−3> 6\,\text{mmol}\,\text{dm}^{-3}.

    • Hemoglobin (HbHb): Threshold of <70 g dm−3< 70\,\text{g}\,\text{dm}^{-3} or an acute drop in concentration of >20 g dm−3> 20\,\text{g}\,\text{dm}^{-3}.

    • Bicarbonate (HCO3HCO_3): Measured at ≤16 mmol dm−3\le 16\,\text{mmol}\,\text{dm}^{-3}.

Code Blue Call Criteria and Definition

A Code Blue is the highest level of hospital emergency response, typically reserved for immediate life-threatening events such as cardiac or respiratory arrest.

  • Cardiovascular Criteria

    • Occurrence of Cardiac arrest.

    • Profound hypotension defined as a Systolic Blood Pressure (SBP) <70 mmHg< 70\,\text{mmHg}.

  • Respiratory Criteria

    • Occurrence of Respiratory arrest.

    • Observation of severe breathing difficulties.

  • Neurological Criteria

    • The patient is found in an unconscious state.