Medical emergency teams and end-of-life care: a systematic review

The medical emergency team (MET) is now common in many hospitals. Apart from early identification and management of patients who are potentially unwell on the ward, the MET may also be involved in end-of-life (EOL) care. It is not known how often METs perform EOL interventions.

We performed a systematic review to identify the frequency of EOL interventions in comparison with other commonly performed interventions during MET calls. We searched PubMed, Embase and bibliographies of retrieved articles. Studies which reported METs that delivered EOL care were included. We assessed the validity of all included studies.

Thirty-five studies met our inclusion criteria. We assessed the frequency of MET interventions and EOL care in 16 studies. Limitations of Medical Therapy (LOMT) were instituted in 1.7% to 30.8% of MET calls. Discussions regarding LOMT were frequently performed more commonly than resuscitation interventions such as endotracheal intubation. None of the included studies reported palliative care interventions after MET calls.

We show that EOL care is commonly delivered during MET calls, and should be emphasised in training for MET members.