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.
  • 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:
    1. GWTG-R data and U.S. annual hospital bed days,
    2. Regression model based on hospital factors and GWTG-R IHCA rates,
    3. Weighted averages for select covariates.
  • 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.

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.

Posted by Stacy AHA Science on Apr 3, 2012 12:18 PM America/Chicago