Emergency call system in the hospital

Introduction

Although there are many people of poor condition in the hospital, they have not been properly managed compared with out-of-hospital patients by the out-of-hospital emergency medical service system. The system of an inhospital medical emergency team (MET) is desired to be set up. Our staff of the Critical Care and Emergency Center functioned as a voluntary MET in response to the inhospital whole paging system. Since 2006, our hospital has adopted the emergency call system as a regular system. The objective of this study was to clarify the usefulness and problems of our MET system.

Methods

We examined the medical records of our MET system (Doctor Call (DC)) for the past 1 year and 8 months.

Results

The data of 34 cases were enrolled. Events occurred in wards or diagnostic and treatment rooms in the outpatients' department in 29% of cases, examination room in 6%, and other nonmedical areas in 65%. Patients were found by the doctor in 21%, nurse in 18%, patients' family in 6%, nonhospital staff including other patients in 12%, and other nonmedical staff in 43%. The reasons why bystanders decided to start the DC system were cardiac arrest in 12%, unresponsiveness in 26%, convulsion in 12%, falling down in 29%, lying in 15%, and others in 6%. In two cases, who were inpatients in their ward, a bystander who found their abnormality (unresponsive and no respiration) at first called a doctor on night duty for the ward before starting up the DC system, with hesitation for using this system because these events occurred at night. We experienced six cases of cardiopulmonary arrest in the DC system including these two cases, 33% of whom were survived without any functional disturbance, 49% died after temporary return of spontaneous circulation, and 18% died without return of spontaneous circulation because of acute aortic dissection in the outpatient department of cardiac surgery during consultation by a specialist. Except for these two cases, patients were managed at first by bystanding doctors before DC in 25%, by MET in 53% within 3 minutes, and by other generalists and specialists in 22% within 2 minutes.

Conclusion

Although our MET system is thought to work well, it needs to be helped by other doctors working nearer the scene than the MET. It is thought necessary to educate the importance of the emergency call and the MET system even at night for all hospital staff.