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Impact of Introduction of Code Blue Response System in a Cardiorespiratory Center: Before-After Study
Sandeep Kumar1, Alok Kumar1, Nihar Ameta1
1Department of Anaesthesia and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India.
Insights
Implementing a Code Blue Response System (CBRS) significantly reduced hospital cardiac arrest response times. This system improved critical interventions, enhancing immediate patient care and survival outcomes.
Area of Science:
- Emergency Medicine
- Cardiology
- Healthcare Systems Management
Background:
- In-hospital cardiac arrest requires rapid intervention to improve survival.
- The Code Blue Response System (CBRS) was developed to optimize emergency response by minimizing delays.
- Evaluating the CBRS's impact on response times and patient outcomes is crucial.
Purpose of the Study:
- To assess the effectiveness of the CBRS in reducing response times.
- To evaluate the impact of CBRS implementation on critical interventions.
- To analyze the association between CBRS and patient outcomes, including return of spontaneous circulation (ROSC).
Main Methods:
- Retrospective analysis of 212 code blue events from April 2023 to March 2025.
- Comparison of pre-CBRS (n=105) and post-CBRS (n=107) groups.
- Analysis of response times, interventions (defibrillation, central venous access), and ROSC rates.
Main Results:
- Mean response time decreased by 35.5% (2.65 to 1.71 min, P < 0.001) post-CBRS.
- Significant increases in defibrillation (P < 0.001) and central venous access (P = 0.03) rates.
- ROSC rate improved from 42.3% to 53.3%, though not statistically significant (P = 0.78).
Conclusions:
- CBRS implementation significantly enhances emergency response efficiency in hospitals.
- The system leads to improved critical interventions and immediate patient outcomes.
- CBRS is a vital strategy for increasing patient survival rates following in-hospital cardiac arrest.
Background:
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.
Materials And Methods:
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.
Results:
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.
Conclusion:
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.
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