Abstract 217: Emergency Department Overcrowding Is Not Associated with Deterioration of Resuscitation Effort, Efficiency and Patient Outcomes in Out-of-Hospital Cardiac Arrest Patients
Background: ED (emergency department) overcrowding is a rampant problem in US. It has been reported that it is associated with poor patient care as well as overall outcomes. Currently it is unknown whether ED overcrowding has significant influence on ED resuscitation for cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) patients. We hypothesised that it has significant impact on the amount of resuscitation effort and long-term outcomes.
Methods: This is a retrospective observational study of OHCA patients resuscitated in ED for prehospital resuscitation failure from 2008 to 2012. Demographic information, Utstein factors and information regarding patient outcomes were retrieved from an OHCA registry. Surrogate markers of ED overcrowding including total number of patients in the ED, the number of patients being cared in critical zone as well as the number of patients boarded for more that two or three days were provided from the administrative department. We also included the number of new patient visits for one hour after the beginning of resuscitation.
Results: 608 patients were included for this study. The total number of patients in ED was not associated with the surrogate markers of resuscitation effort or efficiency which include the duration of resuscitation effort for unresponsive patients and the time to intubation success and first drug administration. Similarly, it was not associated with the chance of prescribing hypothermia after successful resuscitation. Patient outcomes including the chance of achieving sustained ROSC, survival discharge and 6-month cerebral performance category also did not show any significant association.
Conclusion: In this retrospective study of OHCA patients, ED overcrowding did not lead to significant deterioration of resuscitation effort, resuscitation efficiency or long-term outcomes.
Author Disclosures: J. Kang: None. J. Kim: None. Y. Jo: None. K. Kim: None.
- © 2014 by American Heart Association, Inc.