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Five years experience of cardiopulmonary resuscitation in a children's hospital
Insights
Preventing cardiac arrest is crucial, especially for pediatric cardiac patients. Airway issues like endotracheal tube complications were common causes of emergency resuscitation calls, particularly during off-hours.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Critical Care
Background:
- Emergency resuscitation calls are critical events in pediatric hospitals.
- Cardiac patients represent a significant portion of those requiring resuscitation.
- Previous cardiac arrest history increases mortality risk.
Purpose of the Study:
- To analyze the causes and outcomes of emergency resuscitation calls in a children's hospital.
- To identify high-risk patient groups and common triggers for resuscitation.
- To evaluate the effectiveness of resuscitation strategies and preventive measures.
Main Methods:
- Retrospective review of 47 emergency resuscitation attempts in 43 pediatric patients over 5 years.
- Analysis of patient demographics, cardiac history, causes of arrest, and outcomes.
- Comparison of resuscitation success rates and contributing factors.
Main Results:
- 24 out of 43 patients had pre-existing heart diseases.
- Cardiac patients had higher mortality rates post-resuscitation.
- Airway problems, including endotracheal tube complications (13) and obstructions (11), were the most frequent causes.
- Resuscitation calls frequently occurred during weekends, night shifts, or holidays.
- A 30% resuscitation success rate was achieved without a dedicated cardiopulmonary resuscitation (CPR) team.
Conclusions:
- Preventing cardiac arrest, particularly in pediatric cardiac patients, is paramount for improving survival rates.
- Airway management and ensuring adequate staffing during off-hours are critical for reducing emergency calls.
- Initial prevention of cardiac and respiratory arrest is more desirable than emergency interventions.
Abstract:
The emergency call for resuscitation in a children's hospital is reported. Forty-seven resuscitation attempts via the emergency call were made in 43 patients over the past 5 years; 24 out of 43 patients had heart diseases. Cardiac patients were more likely to die within a few days after their resuscitation. The patients, who had previously been in cardiac arrest, lost their lives more often. These results implied that it was very crucial to prevent cardiac arrest especially for cardiac patients in order to save lives. Among the causes of emergency calls, complications with the endotracheal tubes were most common (13) and the airway obstructions followed (11). Summation of two causes, the airway problems, accounted for more than half of the series. Sixteen out of all emergency calls occurred on weekends, and all endotracheal tube troubles broke out during a night shift or on a holiday, that is, the lives of those patients were threatened especially when fewer staff were on duty. Those accidents were embarrassing for us because we believe that all patients must have been under our surveillance all day. Some hospitals have a successful resuscitation rate, organizing a cardiopulmonary resuscitation (CPR) team. However, we obtained better results (about 30%) without a team. It should be borne in mind that it is more desirable to prevent cardiac or respiratory arrests initially rather than save the patients in emergencies.