Resuscitations in an observation unit

The outcome of all resuscitations in a 20-bed observation unit of a large teaching hospital over a 25-month period was reviewed. Resuscitation was defined as a patient receiving one or more of the following: external chest compressions; defibrillation, assisted ventilation (e.g. intubation); and/or advanced cardiac life support drug therapy such as atropine or lidocaine for life threatening dysrhythmias including ventricular tachycardia, ventricular fibrillation, or asystole. There were nine patients out of 10,245 patients admitted to the observation unit (9/10,245 = 0.088% or approximately 0.09%) over the 26-month period from May 1994 to July 1996 who needed resuscitation. Each patient was initially successfully resuscitated. There was only one death (1/10,245 = 0.0098% or approximately 0.01%) in the observation unit. This patient was resuscitated with return of a spontaneous pulse and blood pressure only to expire while awaiting transfer to the Intensive Care Unit (ICU). Eight of the nine patients were admitted to the ICU, four of whom later died, making a total of five deaths (5/10,245 = 0.049% or approximately 0.05%). The other four patients were discharged neurologically intact and at 1 year follow-up were alive and doing well. Compared with resuscitation rates for the prehospital setting, the emergency department, the hospital medical/surgical floors, or the intensive care units, there is a higher successful resuscitation rate for the observation unit.