Background: Medical emergency team (MET) responses have been implemented to reduce inpatient mortality, but data on their efficacy are sparse and there have been no reports to date from US hospitals. Objectives: To determine how the incidence and outcomes of cardiac arrests have changed following increased use of MET. Methods: Objective criteria for MET activation were created and disseminated as part of a crisis management program, after which there was a rapid and sustained increase in the use of MET. A retrospective analysis of clinical outcomes was performed to compare the incidence and mortality of cardiopulmonary arrest before and after the increased use of MET. Results: A retrospective analysis of 3269 MET responses and 1220 cardiopulmonary arrests over 6.8 years showed an increase in MET responses from 13.7 to 25.8 per 1000 admissions (p,0.0001) after instituting objective activation criteria. There was a coincident 17% decrease in the incidence of cardiopulmonary arrests from 6.5 to 5.4 per 1000 admissions (p = 0.016). The proportion of fatal arrests was similar before and after the increase in use of MET. Conclusions: Increased use of MET may be associated with fewer cardiopulmonary arrests.

This paper reports the introduction of electronic handsets, like those used on the television show 'Who Wants To Be A Millionaire?' into the teaching of philosophical logic. Logic lectures can provide quite a formidable challenge for many students, occasionally to the point of making them ill. Our rationale for introducing handsets was threefold: (i) to get the students thinking and talking about the subject in a public environment; (ii) to make them feel secure enough to answer questions in the lectures because the system enabled them to do this anonymously; and (iii) to build their confidence about their learning by their being able to see how they were progressing in relation to the rest of the students in the class. We have achieved all of these and more. Our experience has revealed that the use of handsets encourages a more dynamic form of student interaction in an environment -the lecture -that can, in the wrong hands, be utterly enervating, but they also provide an opportunity for the lecturer to respond to students' difficulties at the time when they really matter. In this paper, we discuss our case of rapid adoption, our grounds for judging it a success, and what that success seems to have depended on.

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