• S Lenkeit, K Ringelstein, I Gräff, and J-C Schewe.
• Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland, stefan.lenkeit@ukb.uni-bonn.de.
• Med Klin Intensivmed Notfmed. 2014 May 1;109(4):257-66.

BackgroundIn-hospital emergencies represent an increasing challenge with regard to risk management in hospitals and until now, no binding recommendations for in-hospital emergency management are available in Germany. Time delays in the detection and treatment of critically ill patients on the wards often lead to serious adverse events. The concept of traditional resuscitation teams is not adequate, because they are initiated only after acute deterioration or cardiac arrest has already occurred.ObjectiveThe introduction of a rapid response system with a preventive approach based on a medical emergency team (MET) represents an essential improvement in the management of in-hospital emergencies. However, it is not sufficient to simply rename and restructure the existing resuscitation team to a MET. Rather, the introduction of standardized preventive alarm criteria and structured processes, standardization of training and emergency equipment in the clinic, and the provision of a MET associated with the intensive care unit are required.ConclusionFor a hospital with an already established resuscitation team, this represents a fundamental paradigm shift to a sustainable, interdisciplinary, and institutionalized process of rethinking and reorganizing. A clear commitment and ongoing joint efforts of the hospital management and all hospital staff are prerequisite for this.

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