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

ABSTRACT Aim A medical emergency team (MET) was introduced to improve early recognition and management of critically ill patients. This study evaluated the impact of MET implementation on emergency airway management in the paediatric intensive care unit (PICU). Methods This single‐centre pre‐post comparative study was conducted from September 2016 to August 2022. Children aged < 16 years who were unexpectedly admitted to the PICU from general wards due to clinical deterioration were included. The primary outcome was emergency tracheal intubation within 1 h of PICU admission. Secondary outcomes were overall intubation rate, PICU stay, and mortality. Fisher's exact and Mann–Whitney U tests were used for univariate analyses, and multivariable logistic regression was performed, adjusting for weight and reason for PICU admission (respiratory failure vs. other causes). Results A total of 12 691 and 25 295 admissions occurred before and after MET implementation, respectively. Unexpected PICU admissions decreased (15.4 vs. 12.7 per 1000, p = 0.04). Emergency intubation within 1 h occurred in 31% pre‐ and 14.3% post‐MET ( p < 0.01). In multivariable analysis, MET implementation was associated with lower odds of emergency intubation (adjusted OR 0.37, p < 0.001). Within the post‐MET cohort, emergency intubation rates did not differ by implementation phase (OR 0.66, p = 0.25) or direct MET activation (OR 1.36, p = 0.60). Conclusion MET implementation was associated with a lower incidence of emergency intubation within 1 h of PICU admission. The findings suggest that improved staff awareness and education, rather than direct MET intervention, promoted timely management of patient deterioration.