Resuscitation Updates from GWTG - Winter 2011-2012
|Impact of Resuscitation System Errors on Survival from In-hospital Cardiac Arrest|
Ornato JP, Peberdy MA, Reid R, Feeser VR, Dhindsa HS; NRCPR Investigators. Resuscitation. 2012 Jan;83(1):63-9. Epub 2011 Sep 29.
- Resuscitation system errors are associated with decreased survival from in-hospital cardiac arrest (IHCA) in adults.
- The most frequent system errors were related to delays in medication, defibrillation and airway management, and chest compression performance errors.
- Hospitals should emphasize the importance of early medication, defibrillation and airway management, and compliance with AHA ACLS protocols in resuscitation training for staff.
|Incidence of Treated Cardiac Arrest in Hospitalized Patients in the United States|
Merchant RM, Yang L, Becker LB, Berg RA, Nadkarni V, Nichol G, Carr BG, Mitra N, Bradley SM, Abella BS, Groeneveld PW; American Heart Association's Get With The Guidelines-Resuscitation (formerly, NRCPR) Investigators. Crit Care Med. 2011 Nov;39(11):2401-6.
As the incidence of IHCA may be increasing, strategies should be developed to address this major healthcare system problem and improve care for in-hospital patients.
- There are about 200,000 treated in-hospital cardiac arrest (IHCA) patients in the U.S. every year.
- Because there is no single database with detailed IHCA incidence information, the annual U.S. event rate of treated IHCAs was estimated by using three methods:
- GWTG-R data and U.S. annual hospital bed days,
- Regression model based on hospital factors and GWTG-R IHCA rates,
- Weighted averages for select covariates.
|In-hospital Cardiac Arrest: Impact of Monitoring and Witnessed Event on Patient Survival and Neurologic Status at Hospital Discharge|
Brady WJ, Gurka KK, Mehring B, Peberdy MA, O'Connor RE; for the American Heart Association's Get With The Guidelines-Resuscitation (formerly, NRCPR) Investigators. Resuscitation. 2011 Jul;82(7):845-52. Epub 2011 Mar 31.
- In-hospital cardiac arrests that are witnessed or monitored lead to a higher rate of survival to hospital discharge than those that are neither witnessed nor monitored.
- Witnessed or monitored cardiac arrests were more likely to achieve favorable neurologic status at hospital discharge.
- There was no significant long-term survival improvement with monitoring compared to direct observation, but monitored-only patients had a higher 24-hour survival rate than witnessed-only patients.