Getting a speedy response to ‘code blue’

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Cardiac arrest happens frequently in hospitals, and efforts have been made in recent years to hasten the response of emergency resuscitation teams. According to a recent study, as many as 30% of in-hospital cardiac arrests from ventricular arrhythmias are not treated within the recommended two minutes or less. A delay of more than two minutes is linked to a 50% lower rate of survival.

It appears no one can be certain he or she is in a hospital with a speedy response time. A study published today in the Archives of Internal Medicine found rates of delayed defibrillation vary widely among hospitals for reasons that are hard to define. For example, traditional factors that suggest a hospital’s level of expertise -- such as patient volume and being a teaching hospital -- were found in the study to be a poor predictor of how well cardiac arrest was handled at such facilities.

The researchers looked at defibrillation practices at 200 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. They found rates of delayed defibrillation -- longer than two minutes -- varied from 2.4% to 50.9% among hospitals. The study had trouble identifying characteristics that seemed related to poor performance, such as hospital size or hospital-wide mortality rates. Only the number of beds in the hospital (larger hospitals performed better) and geographical location (such as whether the patient was in an intensive care unit) were linked to response time. Instead, how a given hospital responds seems to be related to such factors as how the individual hospital approaches the resuscitation process and develops tactics to improve response time, the authors said.

‘This lack of correlation between ‘conventional’ hospital-level factors and defibrillation time suggests that other unmeasured characteristics are responsible for certain institutions achieving extremely low rates of delayed defibrillation,’ the authors wrote.

-- Shari Roan