Abstract 148: Major Differences in In-Hospital Cardiac Arrest Team Member Composition and Lack of Well-defined Tasks - A Nationwide Study
Introduction: In-hospital cardiac arrest carries a poor prognosis. Adverse events and medical errors contribute to increased mortality. Resuscitation system errors are not uncommon and jeopardize survival. Effective leadership and team work may minimize errors during resuscitation and improve survival; this is however challenged because resuscitation is performed by an interdisciplinary ad-hoc team. Currently, no standards for hospital cardiac arrest teams exist. The aim of this study was to describe the member composition of hospital cardiac arrest teams and to review the allocation of tasks.
Methods: All public somatic hospitals in Denmark were eligible for inclusion. Hospitals serving outpatients only or without a well-defined cardiac arrest team was excluded. All Danish hospitals are required to have a mandatory local guideline on resuscitation describing the cardiac arrest team and their respective tasks. These guidelines were collected and systematically reviewed.
Results: In total 54 hospitals were included in the study; data on the cardiac arrest team was available from 45 hospitals. There was a difference of team member composition; average team size: 5.5 (range: 2-9) persons. Teams include a nurse anaesthesiologist (100% of teams), an orderly (75%), a medical resident (67%), an anaesthesiology resident (66%), and a lab technician (32%). Less likely to participate was a cardiology resident (27%) or a senior cardiology doctor (5%). In hospitals with a cardiology department, the cardiac arrest team only include a cardiology doctor in 41% of teams. Only 20% of teams include a senior doctor and 20% of hospitals use a different team during nights and weekends with smaller size and less experienced doctors. Nearly half (47%) of the guidelines do not define a team leader, and the majority of the guidelines do not define the roles of the remaining team. Specifically, it was not defined who should administer drugs (76%), defibrillate (73%), perform chest compressions (58%) or handle the airways (49%).
Conclusion: There are major differences in the composition of members in hospital cardiac arrest teams. Nearly half of the hospitals do not define a team leader and the majority do not define the roles of the remaining cardiac arrest team members.
- © 2013 by American Heart Association, Inc.