Guidelines for Monitoring, Reporting, and Conducting Research on Medical Emergency Team

The majority of patients hospitalized with a cardiac arrest or requiring emergency transfer to the intensive care unit have abnormal physiological values recorded in the hours preceding the event.1–11 Many studies document that physiological measurements often are not made or recorded during this critical time of clinical deterioration.12–16 Such physiological abnormalities can be associated with adverse outcome.17–20 Measurements of abnormal physiology, including temperature, pulse rate, blood pressure, respiratory rate, hemoglobin, oxygen saturation by pulse oximetry, and deterioration of mental status, are therefore important to any system designed for early detection of physiological instability. At a minimum, these measurements must be obtained accurately and recorded with appropriate frequency. A system that both recognizes significantly abnormal values and triggers an immediate and appropriate treatment response is required. /...
Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
New guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) were published in November 2005.1,2 Publication followed a systematic evaluation of scientific evidence that culminated in the 2005 International Consensus Conference on ECC and CPR Science With Treatment Recommendations hosted by the American Heart Association (AHA) in January 2005.3,4 The new treatment recommendations from this meeting incorporated scientific advances made after publication of the 2000 guidelines and were published with the expectation that their worldwide implementation would help improve rates of survival from cardiac arrest and other life-threatening cardiopulmonary emergencies.
A new cycle of evidence evaluation has begun and is expected to be completed in 2010 with the publication of new and revised treatment recommendations. These recommendations will once again reflect the scientific knowledge gained during the intervening period. As the cycle begins, a unique opportunity exists to identify areas in greatest need of clinical research, with the expectation that key questions asked today may be answered in time for the 2010 guidelines. To this end, valuable information was obtained during the evidence evaluation process that led to the 2005 guidelines. Experts appointed to review specific resuscitation topics were asked not only to summarize the existing science but also to identify knowledge gaps. As a result, experts identified knowledge gaps in 276 preassigned topics. We have compiled and organized these knowledge gaps and, through a process of consultation and consensus, identified areas of priority for clinical research.