Improving the Outcome of In-Hospital Cardiac Arrest: The Importance of Being EARNEST

Abstract

Cardiopulmonary resuscitation techniques were introduced more than 50 years ago, yet the rate of survival from cardiac arrest, particularly in the hospital setting, remains dismally low. This article reviews the prevalence, etiology, and outcome of in-hospital cardiac arrest, with a focus on the determinants of outcome that are amenable to improvement. These include principally components of basic life support that may be supported by either prompting or mechanical assistance (eg, chest compression, ventilation, and defibrillation). Also reviewed are preevent and postevent effectors such as medical staff skills and recognition of impending arrest, induction of mild hypothermia, and stabilization after return of spontaneous circulation.

Optimising implementation of a patient‐assessment framework for emergency nurses: A mixed‐method study

“…However, clinical deterioration has been reported to occur undetected by emergency clinicians in as many as one in seven patients in Australian hospital EDs (Scott et al., ). Failure to recognise and respond to clinical deterioration in a timely manner increases the incidence of high‐mortality adverse events such as cardiac arrest and unplanned admissions to the intensive care unit (Dichtwald, Matot, & Einav, ; Haller et al., ; Hogan et al., ). Strategies are needed to improve nursing assessment, recognition and response to clinical deterioration and patient safety in the ED.…”

Survival from in‐hospital cardiac arrest in Auckland City Hospital

“…Cardiopulmonary resuscitation (CPR) and early defibrillation 2 are recognized as standard procedures in the event of a sudden cardiac arrest. Although there has been an improvement in survival reported for in‐hospital arrest between recent studies and those in the past (with earlier studies reporting survival around 10% and more recent studies up to 37%), 3–8 studies from centres with less well‐developed in‐hospital responses to cardiac arrest continue to report poor outcomes 9–11 …”

Improving Code Blue Response Through the Use of Simulation

“…The average survival rate from cardiac arrest in the hospital is approximately 10% (Dichtwald, Matot, & Einav, 2009). The arrest must be identified, and emergency assistance should be summoned immediately.…”