Critical care outreach services are an integral part of ITU management in the UK. It has been stated that ‘’the most sophisticated intensive care often becomes unnecessary terminal care when the pre-ITU system fails ‘’ – which only underlines the importance of early detection, management and flagging up of the critically unwell patient on the ward. Available figures suggest the mortality from in-hospital cardiac arrest is high, with only 15% survival at 1 year. Adverse events such as cardiac arrest, unexpected death and unanticipated intensive care admission are seen from 4 to 17% of admissions; and later analysis often reveals a preventable aspect.