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Impact of Medical Emergency Team Implementation on the Incidence of Emergency Tracheal Intubation in a Paediatric

Kohei Tokioka1, Yuki Nagai1, Kazunori Aoki1

  • 1Centre for Paediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.

Journal of Paediatrics and Child Health
|February 7, 2026
PubMed

Insights

Implementing a medical emergency team (MET) significantly reduced emergency intubations in the pediatric intensive care unit (PICU). This suggests improved staff awareness, not direct intervention, enhances patient care.

Area of Science:

  • Pediatric Critical Care Medicine
  • Emergency Medicine
  • Healthcare Systems Improvement

Background:

  • Medical Emergency Teams (METs) aim to improve recognition and management of critically ill patients.
  • Early airway management is crucial in pediatric intensive care units (PICUs).

Purpose of the Study:

  • To evaluate the impact of MET implementation on emergency airway management in a PICU.
  • To assess changes in emergency tracheal intubation rates and associated outcomes.

Main Methods:

  • A single-centre pre-post comparative study (September 2016 - August 2022).
  • Included children (<16 years) unexpectedly admitted to PICU due to deterioration.
  • Primary outcome: emergency tracheal intubation within 1 hour of PICU admission. Analyzed using multivariable logistic regression.

Main Results:

  • Unexpected PICU admissions decreased post-MET implementation (15.4 vs. 12.7 per 1000).
  • Emergency intubation within 1 hour significantly reduced (31% pre-MET vs. 14.3% post-MET).
  • MET implementation was associated with lower odds of emergency intubation (aOR 0.37, p<0.001).

Conclusions:

  • MET implementation led to a lower incidence of emergency intubation within 1 hour of PICU admission.
  • Findings suggest enhanced staff awareness and education, rather than direct MET intervention, improved patient management.
  • METs may indirectly improve patient outcomes through improved recognition and timely intervention by ward staff.
Abstract

Keywords:
emergency tracheal intubationmedical emergency teampaediatric intensive care unitpatient safety

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