Related Experiment Video
Updated: Oct 14, 2025
05:36
Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
7.9K
A Trigger and Response System for Preventing Cardiac Arrest in the ICU
Ari Moskowitz1,2,3, Katherine M Berg1,2, Michael N Cocchi1,4,5
1Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Boston, MA.
Critical Care Explorations
|November 3, 2021
Summary
A quality improvement initiative using a trigger and response tool did not reduce cardiac arrests in the intensive care unit (ICU). Further research is needed to find effective strategies for preventing ICU cardiac arrests.
Area of Science:
- Critical Care Medicine
- Quality Improvement Science
Background:
- Intensive care unit (ICU) patients are closely monitored, yet some cardiac arrests may be preventable.
- Quality improvement initiatives aim to reduce adverse events in critical care settings.
Purpose of the Study:
- To assess the effectiveness of a novel trigger and response tool in reducing the incidence of cardiac arrest within the ICU.
- To evaluate the impact of a quality improvement initiative on cardiac arrest rates in a tertiary care center.
Main Methods:
- Prospective, observational study conducted in the ICUs of a single tertiary care center.
- Inclusion of patients hospitalized in the ICUs between August 2017 and November 2019.
- Implementation of a comprehensive trigger and response tool as the primary intervention.
Main Results:
- No statistically significant change in the overall cardiac arrest rate was observed after implementing the trigger and response tool (p = 0.28).
- The tool was activated 106 times in one year, most frequently for unexpected hypotension.
- A higher proportion of cardiac arrests were deemed potentially preventable in the preintervention period compared to the intervention period (25.6% vs 12.3%).
Conclusions:
- The implemented trigger-and-response tool did not achieve its primary goal of reducing ICU cardiac arrest frequency.
- Additional research is necessary to identify optimal strategies for the prevention of cardiac arrest in the ICU setting.
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
113
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
113
01:23Cardiopulmonary Resuscitation III: AED Use
123
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
123
01:21Cardiopulmonary Resuscitation I: Adult
168
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
168
01:30Introduction Cardiac Emergencies
66
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
66
01:28Acute Coronary Syndrome IV: Interprofessional Care
49
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
49
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
182
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
182