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Position Statement on Medical Emergency Teams

Medical Emergency Teams (MET), also known under various appellations such as Rapid Response Teams (RRT), Critical Care Response Teams (CCRT) and Rapid Assessment of Critical Events (RACE) teams – are interdisciplinary teams of healthcare practitioners that have expertise in the delivery of care to critically ill patients in pre-cardiac arrest.

Data gathered by the Safer Healthcare Now! Campaign and by the Institute for Health Information conclusively demonstrates that:

• the implementation of METs results in a reduction in mortality associated with cardiac arrest;
• the implementation of METs results in a reduction in ICU admission

METs pool together the unique expertise of each team member. They allow team members to work together as a highly effective unit. By permitting team members to train as a unit, to work together and to cross traditional barriers between disciplines, the implementation of MET significantly improves health outcomes for critically ill patients.

Respiratory therapists are key components of METs. Respiratory deterioration has been identified as a main discriminator in recognizing high-risk patients. 70% of patients show evidence of respiratory deterioration within 8 hours of cardiac arrest.iii Respiratory therapists receive specific training in assessing, monitoring and treating patients that may be demonstrating respiratory compromise. Respiratory therapists are also frequently the first responders to evaluate critical, pre-arrest patients. This practice has allowed respiratory therapists to gain significant experience in applying critical care knowledge outside of the ICU. The respiratory therapists’ skills and experience are therefore particularly conducive to having them to take on an essential role within all METs.

The Canadian Society of Respiratory Therapists (CSRT) supports the implementation of METs.

In relation to the implementation of METs, the CSRT recommends that:

• Based on the critical care knowledge and on the experience of respiratory therapists, every MET should include a respiratory therapist.
• Respiratory therapists have historically played a key role in critical care delivery within their regular duties. They are experienced in performing this role both in and outside of the ICU. Respiratory therapists should therefore be considered as ideal candidates to provide training to METs as well as to take on a leadership role.
• METs should be adequately funded to ensure that team members are provided with training and support.
• MET members should consistently be trained together, as a unit.
• METs’ responses should be monitored and assessed to allow for successful practices to be shared with other teams and for problems to be recorded and addressed.

In order to optimize the benefits of implementing medical rapid response teams, all team members must be equally recognized as such. Members should have the opportunity to train together in order to develop a cohesive response to critical care emergencies and to maximize the efficiency of the team.

The Safer Healthcare Now! Campaign (www.saferhealthcarenow.ca) states that multiple team models work well, including the following:

• ICU RN and Respiratory Therapist (RT)
• ICU RN, RT, Intensivist, Resident
• ICU RN, RT, Intensivist or Hospitalist
• ICU RN, RT, Physician Assistantiv

The very same four models are presented by the Institute for Healthcare Improvement (www.ihi.org).

Respiratory therapists are highly skilled healthcare professionals. They care for patients by evaluating, treating and maintaining cardiopulmonary (heart and lung) function. Respiratory therapists have specialized medical expertise and use advanced medical technology. For more information on respiratory therapy, contact the Canadian Society of Respiratory Therapists at 1 800 267-3422 or e-mail us.

The Canadian Society of Respiratory Therapists (CSRT) is the national professional association representing Canadian respiratory therapists. The CSRT’s mandate is to provide leadership to respiratory therapists in Canada through advocacy, service and unity.

Approved by the CSRT Board of Directors, Summer 2006