Impact of Introduction of Code Blue Response System in a Cardiorespiratory Center: Before-After Study

In-hospital cardiac arrest demands immediate response to improve survival outcomes. The Code Blue Response System (CBRS) was designed to streamline emergency interventions by reducing response times. This study aimed to evaluate the impact of a CBRS on response times and outcomes before and after its implementation.

A retrospective analysis was conducted using "Code Blue" feedback forms collected between April 2023 and March 2025. During this period, 212 patients who experienced code blue events were divided into pre-CBRS (n = 105) and post-CBRS (n = 107) groups, based on whether their code blue event occurred before or after the CBRS installation. Demographic data, response times, interventions (such as defibrillation and central venous access), and return of spontaneous circulation (ROSC) rates were analyzed.

Post-CBRS implementation, the mean response time significantly decreased from 2.65 to 1.71 min (P < 0.001), reflecting a 35.5% reduction. Defibrillation and central venous access rates also increased significantly (P < 0.001 and P = 0.03, respectively), demonstrating the positive impact of CBRS on patient outcomes. Although the ROSC rate improved from 42.3% to 53.3%, the difference did not reach statistical significance (P = 0.78). No significant differences were noted in patient demographics, event location, or time of day.

The implementation of CBRS significantly improved code blue response times and enhanced critical interventions, contributing to better immediate patient outcomes. While the ROSC rate improvement was not statistically significant, the trend suggests a positive clinical impact. CBRS stands out as an essential strategy for improving emergency response efficiency and patient survival rates in hospitals.