[CO2emission]

Hi critical care nurses,
I'm looking for ideas or resources to guide me in designing a referral form or checklist for ward nurses when a patient deteriorates and a review or consult is need from ICU staff or a MET (medical emergency team). For 2 reasons... so that this information can be packaged for a prioritised quick referral and, to act as a record of events for the patient's notes. Any good sites, journals or personal experience etc?
Many thanks and stay happy!

[sharrie]

http://www.bmj.com/cgi/content/abridged/324/7334/387

the BMJ describes a calling criteria here, I have been involved in designing and implementing an observation chart with red areas on that scores patients at risk. When the score reaches a certain level this is a trigger to call the MET team. It has worked really well.

I may still have an electronic copy of our chart, it you PM me your email I can send it to you.

[CO2emission]

Thanks, I would love to see your form....here is a link that you might like and hopefully your organisation has access to the full article http://www.resuscitationjournal.com/...02632/abstract
cheers and many thanks

[sharrie]

Thanks for the link, I will email the chart on Monday when i am back at work.

[danamobile]

our guidlines for making a MET call on the ward are as follows for my hospital:

A- needs artificial airway, increased CO2 above baseline drastically, unable to clear secretions from airway
B- increased RR above 30, below 10 and unable to maintian spot 92% on 10 L mask
c- sbp lower than 100 with substancial drop
other: major change in LOC, bleeding or GENERAL WORRY about a patients condition.

i like the general worry part because a lot of times, its hard to say whats going on, its just not good! it's an excellent resource for a ward nurse! i now work in the icu and see the work in progress

our MET from the last year has decreased codes drastically (im not sure of numbers) and most of the time has been used effectively

[CO2emission]

Thanks for that danamobile,
Often valuable time is wasted because we have to quantify "worry" but there is little argument when we use the MEWS (Modified Early Warning Score). If you GOOGLE this you'll find quite a bit about packaging a patient for referral. Thanks for sharing your practices.