Abstract
Objectives: We aimed to define the Code Blue interventional characteristics at our institution and to put forward a new parameter for the identification of teams’ performance, and to discuss the differences between indoor and outdoor operations. Material and Methods: Our study is a prospective observational survey over an 18-month period between February 1, 2014, and August 1, 2015. The dataset included the call date and the time, the call mode by phone or bystander , the location, time to reach the location, patient’s name and ID number, diagnosis, and the result. Response time was recorded in seconds, and distance between the location and the Emergency Department ED was recorded in meters.Results: During the 18-month study period, 55 code calls occurred. The patients were placed into three groups: policlinic admission patients 63.6%, n=35 , inpatients 12.7%, n=7 , and visitors and hospital personnel 23.6%, n=13 . The mean distance of response points from the ED was 131.1 37–174 meters and the mean response time was 102.4 30–180 seconds. We detected a statistical difference in distance to ED p=0.017 and reach time p=0.013 parameters between indoor and outdoor cases.Conclusions: Outdoor “in-hospital” Code Blue calls and emergency cases have distinct features, which should be further investigated apart from “out of hospital” cardiac arrest and “indoor in-hospital” cardiac arrest cases. The average response speed distance to ED divided by response time may be a suitable parameter for examining the performances of teams in addition to average response time
References
- Thomas K, Force M V, Rasmussen D, Dodd D, Whildin S. Rapid response team: challenges, solutions, benefits. Crit Care Nurse. 2007;27:20–7.
- Kleinman ME, Brennan EE, Goldberger ZD, Swor RA, Terry M, Bobrow BJ, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality. Circulation. 2015;132:S414–35. [CrossRef]
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: Executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;2;122:S640-56. [CrossRef]
- Mäkinen M, Niemi-Murola L, Ponzer S, Kurola J, Aune S, Kurland L, et al. Healthcare professionals hesitate to perform CPR for fear of harming the patient. Vol. 85, Resuscitation. 2014. p. e181–2. [CrossRef]
- Bonafide CP, Localio AR, Roberts KE, Nadkarni VM, Weirich CM, Keren R. Impact of Rapid Response System Implementation on Critical Deterioration Events in Children. JAMA Pediatr. 2014;168:25-33. [CrossRef]
- Choi HJ, Kim GT, Oh SB, Park HS, Oh YH. In-Hospital Cardiac Arrest: Effect of the Performance of Code-Blue Team on Patient Survival. J Emerg Med. 2012;43:945. [CrossRef]
- Edelson DP, Yuen TC, Mancini ME, Davis DP, Hunt EA, Miller JA, et al. Hospital cardiac arrest resuscitation practice in the United States: A nationally representative survey. J Hosp Med. 2014;9:353–7. [CrossRef]
- Kronick SL, Kurz MC, Lin S, Edelson DP, Berg RA, Billi JE, et al. Part 4: Systems of Care and Continuous Quality Improvement. Circulation. 2015;132:S397–413. [CrossRef]
- Sodhi K, Singla MK, Shrivastava A. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital. Indian J Crit Care Med. [CrossRef]
- Huseman KF. Improving code blue response through the use of simulation. J Nurses Staff Dev 2012;28:120–4. [CrossRef]
- Eroglu SE, Onur O, Urgan O, Denizbasi a, Akoglu H. Blue code: Is it a real emergency? World J Emerg Med [Internet]. 2014;5:20–3. [CrossRef]
- Bayramoğlu A, Çakır ZG, Aköz A, Özoğul B, Aslan Ş, Sarıtemür M. Patient-staff safety applications: the evaluation of blue code reports. Eurasian J Med. 2013;45:163–6. [CrossRef]
- Kaernested B, Indridason OS, Baldursson J, Arnar DO. In-hospital cardiopulmonary resuscitation at Landspitali University Hospital in Reykjavik. Laeknabladid. 2009;95:509–14.
- Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia. 2006;47:1499–503. [CrossRef]
- Clawson J, Olola C, Heward A, Patterson B. Cardiac arrest predictability in seizure patients based on emergency medical dispatcher identification of previous seizure or epilepsy history. Resuscitation. 2007;75:298–304. [CrossRef]
- Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346:549–56. [CrossRef]
- Madl C, Holzer M. Brain function after resuscitation from cardiac arrest. Curr Opin Crit Care. 2004;10:213–7.
- Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out- of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 1985;3:114–9.
Abstract
Amaç: Hastanemizin Mavi Kod müdahale özelliklerini tanımlamayı, ekiplerin performansını belirleyebilmek amacı ile yeni bir parametre ortaya koymayı ve bina içinde ve bina dışında yapılan müdahalelerinin farklılıklarını ele almayı amaçladık.Gereç ve Yöntem: Çalışmamız, 1 Şubat 2014 ile 1 Ağustos 2015 tarihleri arasındaki 18 aylık süreyi kapsayan prospektif gözlemsel bir araştırmadır. Veri seti; çağrı tarihi, saati, çağrı şekli telefon veya ayaktan , yer, müdahale süresi, hasta adı, kimlik numarası, tanısı ve sonucu bilgilerini içermektedir. Müdahale süresi saniye, yerin acil servise uzaklığı metre cinsinden kaydedilmiştir. Bulgular: 18 aylık süre içerisinde 55 kod çağrısı meydana geldi. Hastalar üç grupta ele alındı: poliklinik başvuru hastaları 63.6%, n=35 , yatan hastalar 12.7%, n=7 , ziyaretçiler ve hastane çalışanları 23.6%, n=13 . Müdahale yerlerinin acil servise ortalama uzaklığı 131.1 metre, ortalama müdahale süresi 102.4 saniye idi. Bina içi ve bina dışı olguların acil servise mesafe p=0.017 ve ulaşma süresi p=0.013 parametreleri arasında istatistiksel anlamlı fark tespit ettik. Sonuç: Hastane içi bina dışı Mavi Kod çağrıları ve acil olgularının hastane dışı kardiyak arrest ve hastane binası içinde meydana gelen kardiyak arrest olgularından farklı olarak ayrıca incelenmesi gereken farklı özellikleri vardır. Ortalama müdahale hızı acil servise uzaklığın müdahale süresine bölünmesinin sonucu , ekiplerin performansının değerlendirilmesinde ortalama müdahale süresine ek uygun bir parametre olabilir
References
- Thomas K, Force M V, Rasmussen D, Dodd D, Whildin S. Rapid response team: challenges, solutions, benefits. Crit Care Nurse. 2007;27:20–7.
- Kleinman ME, Brennan EE, Goldberger ZD, Swor RA, Terry M, Bobrow BJ, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality. Circulation. 2015;132:S414–35. [CrossRef]
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: Executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;2;122:S640-56. [CrossRef]
- Mäkinen M, Niemi-Murola L, Ponzer S, Kurola J, Aune S, Kurland L, et al. Healthcare professionals hesitate to perform CPR for fear of harming the patient. Vol. 85, Resuscitation. 2014. p. e181–2. [CrossRef]
- Bonafide CP, Localio AR, Roberts KE, Nadkarni VM, Weirich CM, Keren R. Impact of Rapid Response System Implementation on Critical Deterioration Events in Children. JAMA Pediatr. 2014;168:25-33. [CrossRef]
- Choi HJ, Kim GT, Oh SB, Park HS, Oh YH. In-Hospital Cardiac Arrest: Effect of the Performance of Code-Blue Team on Patient Survival. J Emerg Med. 2012;43:945. [CrossRef]
- Edelson DP, Yuen TC, Mancini ME, Davis DP, Hunt EA, Miller JA, et al. Hospital cardiac arrest resuscitation practice in the United States: A nationally representative survey. J Hosp Med. 2014;9:353–7. [CrossRef]
- Kronick SL, Kurz MC, Lin S, Edelson DP, Berg RA, Billi JE, et al. Part 4: Systems of Care and Continuous Quality Improvement. Circulation. 2015;132:S397–413. [CrossRef]
- Sodhi K, Singla MK, Shrivastava A. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital. Indian J Crit Care Med. [CrossRef]
- Huseman KF. Improving code blue response through the use of simulation. J Nurses Staff Dev 2012;28:120–4. [CrossRef]
- Eroglu SE, Onur O, Urgan O, Denizbasi a, Akoglu H. Blue code: Is it a real emergency? World J Emerg Med [Internet]. 2014;5:20–3. [CrossRef]
- Bayramoğlu A, Çakır ZG, Aköz A, Özoğul B, Aslan Ş, Sarıtemür M. Patient-staff safety applications: the evaluation of blue code reports. Eurasian J Med. 2013;45:163–6. [CrossRef]
- Kaernested B, Indridason OS, Baldursson J, Arnar DO. In-hospital cardiopulmonary resuscitation at Landspitali University Hospital in Reykjavik. Laeknabladid. 2009;95:509–14.
- Jenssen S, Gracely EJ, Sperling MR. How long do most seizures last? A systematic comparison of seizures recorded in the epilepsy monitoring unit. Epilepsia. 2006;47:1499–503. [CrossRef]
- Clawson J, Olola C, Heward A, Patterson B. Cardiac arrest predictability in seizure patients based on emergency medical dispatcher identification of previous seizure or epilepsy history. Resuscitation. 2007;75:298–304. [CrossRef]
- Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346:549–56. [CrossRef]
- Madl C, Holzer M. Brain function after resuscitation from cardiac arrest. Curr Opin Crit Care. 2004;10:213–7.
- Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE. Survival of out- of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 1985;3:114–9.
Details
| Primary Language | English |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 1, 2019 |
| Published in Issue | Year 2019Issue: 2 |