Douglas et al reported the most common reasons for the activation of the medical emergency team following non-cardiac surgery. The authors are from Royal Melbourne Hospital and the University of Melbourne in Australia.
Situation: medical emergency team activation, status post non-cardiac surgery.
Most common triggers:
(1) hypotension (systolic blood pressure < 90 mm Hg)
(2) tachycardia (heart rate > 130 beats per minute)
Other triggers:
(1) altered mental status (Glasgow coma scale < 13, or delta GCS >= 2)
(2) hypoxia (SpO2 < 90% on oxygen)
(3) altered respiratory rate (< 8 or > 30 breaths per minute)
(4) increased work of breathing or shortness of breath
(5) clinician concern
(6) cardiac arrest
(7) respiratory arrest or threatened airway
85% of patients had a single activation while 13% had 2.
After discharge from the PACU the time interval to team activation ranged from 4 to 29 hours, with a median of 14.7 hours.
Some of the triggers were associated with underlying risk factors. For example, hypoxia was more common in patients with obstructive sleep apnea, COPD, active smoking, and asthma.
