Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11326
Title: Antecedents to cardiac arrests in a hospital equipped with a medical emergency team.
Authors: Vetro, Joseph;Natarajan, Dinesh K;Mercer, Inga;Buckmaster, Jon N;Heland, Melodie J;Hart, Graeme K;Bellomo, Rinaldo;Jones, Daryl A
Affiliation: Austin Hospital, Melbourne, VIC, Australia.
Issue Date: 1-Sep-2011
Citation: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine; 13(3): 162-6
Abstract: Studies conducted before the conception of medical emergency teams (METs) revealed that cardiac arrests were often preceded by deranged vital signs. METs have been implemented in hospitals to review ward patients whose conditions are deteriorating in order to prevent adverse events, including cardiac arrest. Antecedents to cardiac arrests in a MET-equipped hospital have not been assessed.To determine what proportion of patients who had cardiac arrests had documented MET criteria before the arrest, and what proportion had a premorbid status suggesting they were unsuitable resuscitation candidates.Prospective observational study of cardiac arrests at the Austin Hospital, Melbourne, Australia, 1 April - 30 September 2010. Data were obtained from the patients' records and electronic "respond blue" database.Patients' premorbid medical condition and functional status; prior "not-for-resuscitation" (NFR) order; presence or absence of a MET call before cardiac arrest; time and rhythm of cardiac arrest; and in hospital mortality.27 patients had a cardiac arrest during the study period, 22 of whom had no prior documented NFR order. Among these 22 patients, 18 (82%) had an initial rhythm of asystole or pulseless electrical activity, and 16 (73%) died in hospital. Fifty per cent of arrests were detected between midnight and 08:00. All six patients classified as unsuitable resuscitation candidates died in hospital, and there were trends for increased age and poorer functional status when compared with suitable candidates. A further six patients had documented MET criteria in the 6 hours before the arrest, but did not receive MET review.In this 6-month audit, about half the patients with cardiac arrest may have been unsuitable for resuscitation, or had objective warning signs that were not acted on. Further improvements in advanced care planning and optimisation of MET activation may further reduce cardiac arrest calls at our hospital.
Internal ID Number: 21880003
URI: http://ahro.austin.org.au/austinjspui/handle/1/11326
URL: http://www.ncbi.nlm.nih.gov/pubmed/21880003
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Australia
Cardiopulmonary Resuscitation
Comorbidity
Emergency Medical Services.organization & administration
Female
Heart Arrest.diagnosis.mortality
Hospitalization
Humans
Male
Resuscitation Orders
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