The Impact on Patient Prognosis of Changes to the Method of Notifying Staff About Accepting Patients With Out-of-Hospital Cardiac Arrest

Authors

  • Youichi Inoue Emergency Room, Imamura Hospital
  • Keisuke Okamura Department of Cardiology and Cardiovascular Center, Imamura Hospital
  • Hideaki Shimada Clinical Research Support Center, Fukuoka University Chikushi Hospital
  • Shinobu Watakabe Emergency Room, Imamura Hospital
  • Shiori Hirayama Emergency Room, Imamura Hospital
  • Machiko Hirata Emergency Room, Imamura Hospital
  • Ayaka Kusuda Emergency Room, Imamura Hospital
  • Arisa Matsumoto Emergency Room, Imamura Hospital
  • Miki Inoue Emergency Room, Imamura Hospital
  • Emi Matsuishi Emergency Room, Imamura Hospital
  • Mizuki Yamada Emergency Room, Imamura Hospital
  • Sachiko Iwanaga Saga University Hospital Trauma And Resuscitation
  • Shogo Narumi Saga University Hospital Trauma And Resuscitation
  • Shiki Nakayama Department of Emergency, Takagi Hospital
  • Hideto Sako Department of Cardiology and Cardiovascular Center, Imamura Hospital
  • Akihiro Udo Department of Cardiology and Cardiovascular Center, Imamura Hospital
  • Kenichiro Taniguchi Department of Cardiology and Cardiovascular Center, Imamura Hospital
  • Shogo Morisaki Department of Cardiology and Cardiovascular Center, Imamura Hospital
  • Souichiro Ide Department of Respiratory Medicine, Imamura Hospital
  • Yasuyuki Nomoto Department of Neurosurgery, Imamura Hospital
  • Shin-ichiro Miura Department of Cardiology, Fukuoka University School of Medicine
  • Osamu Imakyure Clinical Research Support Center, Fukuoka University Chikushi Hospital
  • Ichiro Imamura Department of Surgery, Imamura Hospital

DOI:

https://doi.org/10.14740/jocmr6111

Keywords:

Emergency room, Cardiopulmonary resuscitation, Return of spontaneous circulation, Out-of-hospital cardiac arrest

Abstract

Background: Our hospital is a designated emergency hospital and accepts many patients with out-of-hospital cardiac arrest (OHCA). Previously, after receiving a direct call from emergency services to request acceptance of an OHCA patient, the emergency room (ER) chief nurse notified medical staff. However, this method delayed ER preparations, so a Code Blue system (CB) was introduced in which the pending arrival of an OHCA patient was broadcast throughout the hospital.

Methods: In this study, we retrospectively analyzed the impact of introducing CB at our hospital on OHCA patient prognosis to examine whether the introduction of CB is clinically meaningful. We compared consecutive cases treated before introduction of the CB (March 3, 2022, to March 22, 2023) with those treated afterwards (March 23, 2023, to July 23, 2024).

Results: A total of 30 cases per group were included. The mean number of medical staff present at admissions increased significantly from 5.4 ± 0.6 to 15.0 ± 3.0 (P < 0.001). Although not statistically significant, the introduction of the CB increased the return of spontaneous circulation (ROSC) rate from 20% to 30%, survival to discharge rate from 3% to 10%, and social reintegration rate from 0% to 3%. ROSC occurred in 15 patients. Among OHCA patients with cardiac disease, the ROSC rate tended to increase from 0% to 43% (P = 0.055). In addition, in OHCA patients with cardiac disease whose electrocardiogram initially showed ventricular fibrillation or pulseless electrical activity, the ROSC rate increased from 0% to 100%. ROSC tended to be influenced by the total number of staff and physicians present and the number of staff such as medical clerks, clinical engineers, and radiology technicians (P = 0.095, 0.076, 0.088, respectively).

Conclusions: Introduction of a CB may increase the ROSC rate and the number of patients surviving to discharge. It also appears to improve the quality of medical care by quickly gathering all necessary medical staff so that they can perform their predefined roles.

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Published

2024-12-21

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Section

Original Article

How to Cite

1.
Inoue Y, Okamura K, Shimada H, et al. The Impact on Patient Prognosis of Changes to the Method of Notifying Staff About Accepting Patients With Out-of-Hospital Cardiac Arrest. J Clin Med Res. 2024;16(12):578-588. doi:10.14740/jocmr6111