What is a ‘MET’ Call?
MET stands for medical emergency team, and is a group of nurses and doctors who respond to the patient’s bedside when a MET call is activated. A MET call is activated when a patient deteriorates suddenly, or has vital signs which are significantly deranged from the physiological norm. Although a MET call will be activated when a cardiac or respiratory arrest occurs, majority of MET calls are in patients who are alive, but require urgent medical intervention.
The most common MET call is for hypotension.
Below is a non-extensive list of reasons a MET call may be activated:
- Cardiac or respiratory arrest
- Hypotension (SBP<80mmHg)
- Severe tachycardia (>140/min)
- Severe bradycardia (<30/min)
- Life-threatening ECG/arrhythmia (e.g. VT, STEMI)
- Reduced GCS/loss of consciousness
- Tachypnoea (>36/min)
- Extremely low respiratory rate (<4/min)
- Hypoxia (SpO2<84%)
- Possible stroke (at MET must be activated before a code stroke can be activated)
- Severe haemorrhage
- ADDS score >8
Finally, it is important to realise a MET call can be activated for any patient of concern, by any member of staff. If you are concern a patient is unwell and needs urgent medical attention, you can activate a MET call.
To activate a MET call, dial ’55’ and state code blue, following by your location. If you are at the bedside, also press the “emergency” button at the patient bedside. This will activate an alarm which will alert the rest of the ward that you need urgent help. Pressing this button however will not activate the MET team.
Attending a MET Call
Attending a MET call can be an exciting part of a placement. However, for students, it can also be difficult to know exactly what to do in a MET call, and how to make yourself useful to the team.
Below are some suggestions on how to get involved in the MET call as a student.
1. Offer to get the patient notes
The MET team heavily rely on the inpatient notes to help them quickly learn about the patient any why they are in hospital. It’s very useful if those notes are at the bedside when they arrive. If you know where the notes are kept – take the initiative to quickly collect them and bring them to the patient’s bedside. Similarly, if it is available, also collect the patient’s hospital record (manila file) as it will contain old ECG’s, etc, which will be useful during the MET call.
2. Offer to check the patient’s previous blood results/imaging
Very rarely is a computer available at the patient’s bedside. Offer to leave the bedside to check the patient’s blood results. If you can, print a copy of the results or jot them down on a piece of paper to take back to the bedside. At a pinch, you could take a de-identified photo of the results to show the MET team. Always be sure to double check you have the correct patient results first!
Similarly, the MET team often want to know when the patient last had a chest x-ray or other imaging (e.g. CT brain) during the admission.
3. Offer to call radiology for an urgent portable chest x-ray
Pick up the phone and call radiology. Be sure to emphasise it is a MET call and give details of which ward and patient room. They will also ask you for the patient details – so take a patient sticker with you from the bedside.
4. Speak up if you know something about the patient!
Often the MET team won’t know anything about the patient, and rely on the medical notes and the ward staff present to inform them about the patient. Especially on busy wards with high patient turnover, even the treating team won’t know everything about the patient. It may be that you took a history from the patient earlier in the morning, or was with the registrar when the patient was clerked on admission. This makes you a key source of information during the MET call. Don’t be afraid to speak up if you know something about the patient – the MET team will always be grateful.
Save your questions until the end of the MET call
MET calls can be a good learning opportunity where you see lots of medicine put into practice. You may have lots of questions about why the MET team made certain decisions, or would like someone to guide you through how the ABG/ECG was interpreted. MET calls are often busy and chaotic, so it’s best to save your questions till the end so the team can focus on the sick patient.