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Introduction: Cardiopulmonary resuscitation is a sequence of techniques that combines chest compression with artificial ventilation to manually maintain the circulation to preserve intact brain function. The aim is to maintain circulation and breathing in a person who is in cardiac arrest until emergency aid arrives. Effective teamwork by Code Blue team raises chances of a successful outcome. The advanced cardiac life support (ACLS) guidelines were developed by the American Heart Association using the comprehensive review of resuscitation literature performed by the International Liaison Committee on Resuscitation. Aim: To assess adherence of Code Blue team to ACLS protocol, to assess outcome of resuscitation, and to compare outcome between those where ACLS guidelines were followed and those not followed. Patients and Methods: A clinical audit was done between 2014 and 2015 at Lourdes Hospital, Kochi, on inpatients aged between 30 and 80 years, with witnessed cardiac arrests/respiratory arrest. Pregnant and unwilling patients were excluded. Results: The common arrest rhythm was pulseless electrical activity, followed by asystole. ACLS protocol was followed in 58.7%. The most common deviation was usage of inappropriate drugs. Return of spontaneous circulation (ROSC) was attained in 53.3%, of which 28.5% were discharged (P < 0.05), which suggests a significant association between the adherence to ACLS protocol and ROSC. Conclusion: Although Code Blue team is ACLS trained, deviations occurred in nearly half of the resuscitations, which need to be reduced. Outcome was better in those resuscitations where the ACLS protocol was followed.

Introduction: Cardiac arrest continues to be a common cause of in-hospital deaths. Even small improvements in survival can translate into thousands of lives saved every year. Aim: The aim of our prospective observational study was to elicit the outcomes and predictors of in-hospital cardiopulmonary resuscitation among adult patients. Settings and Design: All in-hospital adult patients (age >14) who suffered cardiac arrest & were attended by a Code Blue Team between 1st January 2012 & 30th April 2013 were part of the study. Materials and Methods: The cardiopulmonary resuscitation (CPR) was assessed in terms of: Response time, Presenting initial rhythm, Time to first defibrillation, Duration of CPR and Outcome (Return of spontaneous circulation (ROSC), Glasgow outcome scale (GOS) at discharge). Statistical Analysis: Age, GOS and mean response time were analysed using t-test and ANOVA. Logistic regression was applied to determine the significance of the various factors in determining mortality. Results: ROSC was achieved in 44% of a total of 127 patients included in our study. Asystole/Pulseless electrical activity (PEA) was the most common presenting rhythm (87.5%). The survival to discharge was seen in 7.1% patients of whom only 3.9% patients had good neurological outcome. Regression and survival analysis depicted achievement of ROSC during CPR, absence of co-morbidities and shorter response time of code blue team as predictors of good outcome. Conclusion: We found poor outcome of CPR after in-hospital cardiac arrest. This was mainly attributed to an initial presenting rhythm of Asystole/PEA in most cases and delayed response times.

Introduction: Cardiac arrest continues to be a common cause of in-hospital deaths. Even small improvements in survival can translate into thousands of lives saved every year. Aim: The aim of our prospective observational study was to elicit the outcomes and predictors of in-hospital cardiopulmonary resuscitation among adult patients. Settings and Design: All in-hospital adult patients (age >14) who suffered cardiac arrest & were attended by a Code Blue Team between 1st January 2012 & 30th April 2013 were part of the study. Materials and Methods: The cardiopulmonary resuscitation (CPR) was assessed in terms of: Response time, Presenting initial rhythm, Time to first defibrillation, Duration of CPR and Outcome (Return of spontaneous circulation (ROSC), Glasgow outcome scale (GOS) at discharge). Statistical Analysis: Age, GOS and mean response time were analysed using t-test and ANOVA. Logistic regression was applied to determine the significance of the various factors in determining mortality. Results: ROSC was achieved in 44% of a total of 127 patients included in our study. Asystole/Pulseless electrical activity (PEA) was the most common presenting rhythm (87.5%). The survival to discharge was seen in 7.1% patients of whom only 3.9% patients had good neurological outcome. Regression and survival analysis depicted achievement of ROSC during CPR, absence of co-morbidities and shorter response time of code blue team as predictors of good outcome. Conclusion: We found poor outcome of CPR after in-hospital cardiac arrest. This was mainly attributed to an initial presenting rhythm of Asystole/PEA in most cases and delayed response times. [ABSTRACT FROM AUTHOR]

Abstract: Background: Recent studies suggest that time of day affects survival from in-hospital cardiac arrest. Lower survival rates are observed during nights and on weekends, except in areas with consistent physician care, such as the Emergency Department. Since 1997, our hospital has utilized a standard, hospital-wide “Code Blue Team” (CBT) to respond to cardiac arrests at any time. This team is always led by an emergency physician, and includes specially trained nurses. Objective: To assess if time of day or week affects survival from in-hospital cardiac arrest when a trained, consistent, emergency physician-led CBT is implemented. Methods: This is an analysis of prospectively collected data on initial survival rates (return of spontaneous circulation >20 min) of all cardiac arrests that were managed by the CBT from 2000 to 2008. Cardiac arrests were also subcategorized based on initial cardiac rhythm. Survival rates were compared according to time of day or week. Results: A total of 1692 cardiac arrests were included. There was no significant difference in the overall rate of initial survival between day/evening vs. night hours (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.83–1.29), or between weekday vs. weekend hours (OR 1.10, 95% CI 0.85–1.38). This held true for all cardiac rhythms. Conclusion: At our institution, there is no significant difference in survival from cardiac arrest when a standardized “Code Blue Team” is utilized, regardless of the time of day or week. [Copyright &y& Elsevier]