Pattern of detection of cardiac arrests was unaffected by the introduction of medical emergency team:reply to Smith et al.

Excerpt

Sir: We thank Dr. Smith and colleagues for their interest in our manuscript and provide the following points for clarification. We do not believe we have attempted to assess or present any data on the effect of the introduction of the MET service on the timing or incidence of cardiac arrests in the manuscript in question. Instead, as stated in the objective of the abstract, we aimed “to describe the timing of cardiac arrest detection in relation to episodes of Medical Emergency Team (MET) review and routine nursing observations”. We agree with Smith and colleagues that the hourly distribution of arrests is predominantly unchanged in both figures. As stated in our manuscript, cardiac arrest detection occurs predominantly overnight, when review by staff is likely to be lowest. In addition, the rate of activation of the MET overnight is lower than in the day, further suggesting less review by staff overnight. These observations have important consequences for the detection of patients who are unwell. As stated by DeVita, the “more care givers that visit a patient, the more likely they are to detect patient deteriorations” [1]. …