An audit of in-hospital crash team interventions outside critical care areas

All in-hospital interventions by the crash team of our hospital were recorded and evaluated retrospectively from 1 January 1992 to December 1994 and prospectively for 1995. The most frequent diagnosis was some type of cardiac arrest with a maximal incidence of 32.4% in 1994. Intubation was required in 58.7% of the cases in 1995. Outcome is better on surgical wards and for emergencies in the catheter laboratory compared with medical wards. The inappropriate overruling of the 'do not attempt resuscitation' (DNAR) policy eventually resulted in one survivor. We identified at least five cardiac arrest patients with an unacceptable delay in advanced life support. Our in-hospital critical incident registry resulted in a better policy for appropriate and timely intensive care unit referral.