Ward staff requiring urgent review of deteriorating patients, must initiate an MET call via the Hospital switchboard. The switchboard will then issue an ‘MET call’ via the emergency paging system. This will send a message for the MET team to attend urgently. The MET team is comprised of the Medical Registrar (MET Team Leader), Anaesthetic Registrar and the ICU Registrar.
During the day, the ICU Registrar who is carrying the MET pager will attend the MET/cardiac arrest/trauma call. The ICU Senior Registrar need only attend as a back-up if required by the ICU Registrar.
At night, one of the Night Registrars, will carry the MET pager and attend the MET / cardiac arrest.
All Emergency Department, Operating Theatre and Out-of-Hospital initiated referral calls to ICU should be passed to the senior registrar on 7571, 24 hours a day, 7 days a week.
In business hours, this will be answered by the on-site ICU Senior Registrar (SR) After-hours the SR will review or call in person. If the SR is offsite he will ask the registrar to review and liaise regarding the potential admission to the ICU.
An exception to the rule of urgent review is as follows. For ward patients admitted under a specialist, an ICU Consultation can be initiated by someone of Registrar level or above by contacting the ICU Senior Registrar (pager via switch) 24/7 on 7571.This referral must never be delegated to a more junior member of the referring medical team or ICU team. The Registrar must have first discussed the need for referral to ICU with the primary Consultant (or the designated on-call Consultant for that particular specialty or sub-specialty).
If the patient is unwell and breaches the calling criteria after the referral then and MET call should be initiated. Referral is not a substitute for MET. And Urgent reviews would warrant a clinical review or MET as deemed appropriate by the team.
Any patient in whom 2 or more MET calls have been made within 24 hours or the teams are concerned must be discussed with an ICU Consultant.
IT IS NOT ADVISABLE FOR TEAMS TO RING THE ICU DIRECTLY TO SPEAK TO an ICU Registrar as it affects the clinical work and does not identify the right person. This can be used to escalate if the pager has not been answered for whatever reasons.