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Understanding Code Blue Activations: Insights From Early Warning and Palliative Scores in a Tertiary Hospital

Gezy Weita Giwangkancana1, Yani Gezy Setiasih2, Anisa Hasanah2

  • 1Department of Anesthesia and Intensive Care, Faculty of Medicine Universitas Padjadjaran / Dr. Hasan Sadikin National Referral and Teaching Hospital, Bandung, Indonesia.

Open Access Emergency Medicine : OAEM
|February 3, 2025
PubMed

Insights

In-hospital cardiac arrest (IHCA) events can be predicted using early warning scores (EWS) and palliative care scores. Implementing these systems can help reduce Code Blue activations and improve patient outcomes.

Area of Science:

  • Medical Science
  • Emergency Medicine
  • Critical Care

Background:

  • In-hospital cardiac arrest (IHCA) presents a significant challenge in healthcare settings.
  • Code Blue activations are critical emergency responses to IHCA.
  • Understanding IHCA frequency and outcomes is vital for improving patient care.

Purpose of the Study:

  • To determine the frequency, demographics, and outcomes of Code Blue activations.
  • To analyze the role of Early Warning Scores (EWS) and palliative scores in IHCA.
  • To assess the impact of these scores on patient outcomes in a low-middle-income country.

Main Methods:

  • Retrospective observational study of 2184 Code Blue activations from 2017-2023.
  • Inclusion of Early Warning Scores (EWS) and palliative scores from 2021 onwards.
  • Statistical analysis to correlate scores with patient outcomes.

Main Results:

  • IHCA incidence was 5.46 per 1000 visits, with peak activations in 2019.
  • Average return of spontaneous circulation (ROSC) was 17.7% annually.
  • Mean EWS and palliative scores for Code Blue activations were 9.2 and 7.8, respectively.

Conclusions:

  • Early warning systems and palliative care scoring can predict Code Blue activations.
  • Management based on these scores may reduce IHCA incidence.
  • Integrating these scores into hospital protocols can enhance patient outcomes and resource allocation.
Abstract

Keywords:
In-hospital cardiac arrestcode blueearly warning scoreemergency responsepalliative careresuscitation

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