Abstract 249: Improving Care for in-Hospital Cardiac Arrest Patients — The Rock Study
Background: Cardiac arrest is a race against time. Every minute counts. Guidelines stipulate defibrillation within 3 minutes in the hospital setting. In 2004 the average time between cardiac arrest to defibrillation at our hospital was 4.50 minutes. The aim of this study was to evaluate how introduction of automatic external defibrillators (AED) could shorten time from cardiac arrest to defibrillation preparedness.
Material and methods: 48 wards and outpatient clinics were randomized and included in either intervention or standard care group. Intervention group units were equipped with AED's and the staffs were trained to use them. In this group CPR + AED training took place four times a year. Units in the standard care group continued with CPR training once a year. Units in both groups continued to call for the mobile emergency treatment (MET) team when cardiac arrests were suspected but the intervention group now had AED's available on site to aid their patients. Patients with suspected cardiac arrest where staff performed CPR and an AED was used either by the MET or by the unit's staff are included in the material. Data has been gathered from patient records, AED's and the Swedish national registry for in-hospital cardiac arrest
Results: A total of 126 cardiac arrests occurred during the study period. 79 in intervention group and 47 in standard care. Data shows that intervention group AED's were in use before arrival of the MET in 83 % of the cases. In 42 instances we had the opportunity to analyze the time frame from start-up of the AED until MET team arrival. The AED's was prepared to be used 99 seconds (mean) (range 14 – 423 s) before arrival of the MET team.
Conclusion: If AED's are made accessible at hospitals, in wards or out-patient clinics, they are used and often used before the arrival of the MET team. A concept where the first in line to respond to a cardiac arrest has opportunity and competence to use it is most likely to increase survival for the in-hospital cardiac arrest patient.
- © 2010 by American Heart Association, Inc.