Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital

Hodgetts, Timothy; Kenward, Gary; Vlackonikolis, Ioannis; Payne, Susan N.; Castle, Nick; Crouch, Robert; Ineson, N; Shaikh, Loua Al

doi:10.1016/s0300-9572(02)00098-9

Cited by 368 publications

(232 citation statements)

References 23 publications

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“…1,[3][4][5][6][7]19,20,26 Based on our findings, the majority of cases of IHCA that occur in the general ward are non-cardiac. There are several possible explanations for differences in survival to hospital discharge after IHCA in the general ward.…”

Section: Discussionsupporting

confidence: 60%

“…1,2 Many studies have reported survival to discharge rates of 15-20% for IHCA, which are much lower than the rates for out-of-hospital cardiac arrest. 1,[3][4][5][6][7] A few studies report higher survival-to-discharge rates, of up to 45% by the Medical Emergency Team activities. [8][9][10] In addition, the incidence of IHCA has been reported as 1-4 arrests per 1,000 patient admissions.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] In addition, the incidence of IHCA has been reported as 1-4 arrests per 1,000 patient admissions. 4,11,12 However, there are few studies on the epidemiology and clinical outcomes of IHCA cases in general wards. Also, the response to IHCA in general wards is expected to be less efficient than in the ICU because of delayed diagnosis, poor monitoring, and the lack of equipment and well trained staff.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

et al. 2013

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The main outcomes included survival to hospital discharge, incidence of IHCA, and prognostic factors related to hospital mortality. We also investigated preventable cases. RESULTS: We identified 238 index cases of IHCA. The average incidence of IHCA was 0.145 IHCAs per 1,000 patient admissions. Survival to hospital discharge was 19% (46 cases), 66% of which were due to non-cardiac causes, and 77% were due to medical illnesses. The most common first documented rhythm was pulseless electrical activity (38%). Two hundred three cases (85.3%) of IHCA were witnessed at the event; 135 cases (56.7%) were monitored at the event. Non-witnessed cases, monitored cases, night onset, medical illness, metastatic cancer, intubation, and long duration of cardiopulmonary resuscitation were significantly associated with hospital mortality. We identified 91 preventable cases (38%). Respiratory insufficiency (37 cases, 41%) was one of major cause of preventable IHCA. CONCLUSIONS: Witnessed IHCAs in the general ward had a higher rate of survival to hospital discharge; however, monitored cases had a lower rate of survival to hospital discharge. Respiratory insufficiency was a major preventable cause of IHCA. In consideration of the preventable IHCAs, further studies should be performed on monitoring practices in general wards.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

et al. 2013

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“…The onset of critical illness appears to be often predictable (Schein et al 1990). More effective rescue at an earlier stage is likely to lead to both health and economic gains by reducing cardiac arrests, intensive care unit (ICU) admissions and mortality rates (Buist et al 1999, Hodgetts et al 2002. This includes the timely management of severe maternal morbidity (for example, sepsis, post-partum haemorrhage and pre-eclampsia).…”

Section: A Focus On Rescue In the Context Of Acute Illnessmentioning

confidence: 99%

The Social Practice of Rescue: The Safety Implications of Acute Illness Trajectories and Patient Categorisation in Medical and Maternity Settings

Mackintosh¹,

Sandall²

2016

The Sociology of Healthcare Safety and Quality

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The normative position in acute hospital care when a patient is seriously ill is to resuscitate and rescue. However, a number of UK and international reports have highlighted problems with the lack of timely recognition, treatment and referral of patients whose condition is deteriorating while being cared for on hospital wards. This article explores the social practice of rescue, and the structural and cultural influences that guide the categorisation and ordering of acutely ill patients in different hospital settings. We draw on Strauss et al.'s notion of the patient trajectory and link this with the impact of categorisation practices, thus extending insights beyond those gained from emergency department triage to care management processes further downstream on the hospital ward. Using ethnographic data collected from medical wards and maternity care settings in two UK inner city hospitals, we explore how differences in population, cultural norms, categorisation work and trajectories of clinical deterioration interlink and influence patient safety. An analysis of the variation in findings between care settings and patient groups enables us to consider socio-political influences and the specifics of how staff manage trade-offs linked to the enactment of core values such as safety and equity in practice.

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“…Research in adults demonstrated that cardiopulmonary arrest or emergency admissions to Intensive Care were often preceded by a period of physiological instability which, once recognised, provided an opportunity for the healthcare team to intervene to improve outcome (Hodgetts et al, 2002;Kause et al, 2004). A similar window of opportunity may exist for hospitalised children (Haines, 2005;Tasker, 2005;Tume, 2004Tume, , 2006.…”

Section: Introductionmentioning

confidence: 99%

What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Sefton

McGrath

Tume

et al. 2015

Intensive and Critical Care Nursing

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Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital

Cited by 368 publications

References 23 publications

Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

The Social Practice of Rescue: The Safety Implications of Acute Illness Trajectories and Patient Categorisation in Medical and Maternity Settings

What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

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