A standardized Code Blue Team eliminates variable survival from in-hospital cardiac arrest

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Cardiology

Background:

• Studies indicate time of day influences in-hospital cardiac arrest survival.
• Lower survival rates are often seen during nights and weekends.
• Consistent physician care, like that in an Emergency Department, may mitigate this effect.

Purpose of the Study:

• To evaluate if time of day or week impacts survival from in-hospital cardiac arrest.
• To assess the effectiveness of a standardized, physician-led Code Blue Team (CBT) in mitigating temporal variations in survival.

Main Methods:

• Analysis of prospectively collected data on initial survival rates (return of spontaneous circulation >20 min) from 2000-2008.
• Cardiac arrests managed by the hospital-wide CBT were subcategorized by initial cardiac rhythm.
• Survival rates were compared based on time of day and day of the week.

Main Results:

• 1692 cardiac arrests were analyzed.
• No significant difference in initial survival rates was found between day/evening and night hours (OR 1.04, 95% CI 0.83-1.29).
• No significant difference in initial survival rates was observed between weekdays and weekends (OR 1.10, 95% CI 0.85-1.38).

Conclusions:

• Implementation of a standardized, emergency physician-led Code Blue Team (CBT) negates the impact of time on cardiac arrest survival.
• Survival rates for in-hospital cardiac arrest remain consistent regardless of the time of day or week at this institution.
• This suggests a standardized, multidisciplinary team approach ensures equitable care during critical events.