Document Detail


In-hospital cardiac arrest: survival depends mainly on the effectiveness of the emergency response.
MedLine Citation:
PMID:  15325448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the factors affecting the outcome of in-hospital cardiac arrest. SETTING: A 1400-bed tertiary care teaching hospital with a dedicated cardiac arrest team (CAT). The CAT was immediately available in monitored areas (intensive care unit and emergency room). In the wards the staff had only BLS skills and automated external defibrillation was not available. METHODS: A 2-year prospective audit according to the Utstein style. RESULTS: A total of 114 cardiac arrests (37 with VF/VT and 77 with non-VF/VT) were included. Fifty-two cardiac arrests (46%) occurred in monitored areas, 62 (54%) occurred in non-monitored areas. The CAT arrival time in non-monitored areas was 3.98+/-1.73 min. Thirty-seven patients (32%) survived to hospital discharge. Cardiac arrests occurring in monitored areas had a significantly better outcome than those occurring in the wards. Patient survival in the wards was significantly higher when the CAT arrival time was less than 3 min. No patient whose CAT arrival time was longer than 6 min survived. CAT arrival time was significantly shorter (1.30+/-1.70) in survivors than in non-survivors (2.51+/-2.37; P<0.005). Sex, age and presence of bystanders were not significantly associated with survival. CONCLUSIONS: In our setting, where bystander defibrillation was not available, the survival of patients having cardiac arrest in non-monitored areas strongly depends on advanced life support provided by the CAT. A faster CAT response and early defibrillation from the ward staff are the most important improvements necessary to increase cardiac arrest survival in our setting.
Authors:
Claudio Sandroni; Giorgia Ferro; Susanna Santangelo; Francesca Tortora; Lorenza Mistura; Fabio Cavallaro; Anselmo Caricato; Massimo Antonelli
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  62     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-24     Completed Date:  2004-12-10     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  291-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, Catholic University School of Medicine, Largo Gemelli 8, 00168 Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / methods,  mortality*
Electric Countershock / statistics & numerical data*
Emergencies
Emergency Service, Hospital / standards*
Female
Heart Arrest / mortality*,  therapy*
Hospital Mortality / trends*
Humans
Intensive Care Units
Italy
Male
Medical Audit*
Middle Aged
Patient Care Team / standards*
Prognosis
Prospective Studies
Quality of Health Care
Risk Factors
Sex Factors
Survival Analysis
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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