Code Blue evaluation in children's hospital / 世界急诊医学杂志（英文）

@#BACKGROUND: True alarm rate of the Code Blue cases is at a low level in the Dr. Beh?et Uz Children''s Hospital in ?zmir. This study aims to analyse the use of the Code Blue alarm cases in the children''s hospital.METHODS: This retrospective clinical study evaluated the age and the gender of the cases, the arriving time of the Code Blue team, the date and time of the Code Blue Call, the reasons of the Code Blue Call, and the verifi cation which were all obtained from the Code Blue forms of the hospital dated between January 2014 and January 2015. The data of 139 Code Blue cases'' forms were investigated and was divided into two groups: before and after the education containing 88 and 51 cases, respectively.RESULTS: Conversive disorder (26％ to 13％,P<0.01), syncope (21.5％ to 19.6％,P<0.01), convulsion (17％ to 13.7％,P<0.01), hypoglycemia (4.5％ to 3.9％,P<0.01), anxiety (4.5％ to 1.9％, P<0.01), head trauma due to syncope (4.5％ to 0％), cardiac arrest (1.1％ to 0％), respiratory difficulties (2.2％ to 1.9％,P<0.01), suspicion of myocardial infarction (2.2％ to 1.9％,P<0.01), fall from stairs (2.2％ to 0％) and agitation cases (1.1％ to 0％) were reduced, however, the hypertension cases were dramatically increased (3.4％ to 29.4％,P<0.01) owing to the hospital staff''s education. The Pearson''s correlation coeffi cient before and after education was 0.837. About 97.8％ of the Code Blue cases were false calls with female greater than male (P<0.01).CONCLUSION: The results of this study show that more education is required for the hospital''s staff and a new color code that is to say pre-diagnosis team should be formed.

Effectiveness of a Cardiopulmonary Resuscitation Team with an Emergency Physician for In-Hospital Cardiac Arrest

PURPOSE: Emergency physicians are usually more experienced in emergency situations; therefore, a cardiopulmonary resuscitation team with an emergency physician as a leader would be operated effectively. The aim of this study is to evaluate the effectiveness of a cardiopulmonary resuscitation that includes an emergency physician. METHODS: A retrospective analysis for in-hospital arrests that occurred in the general ward was conducted based on the in-hospital cardiopulmonary resuscitation registry of a tertiary care university hospital in Korea from January 1, 2005 through December 31, 2010. We compared outcomes of cardiopulmonary resuscitation performed by a team that included an emergency physician with those by a cardiopulmonary resuscitation team that included a non-emergency physician. RESULTS: Survival rates at discharge were 29.6% for the emergency physician team and 17.7% for the non-emergency physician team. The good neurologic outcome rates at discharge were 20.6% and 10.6%, respectively. In multivariate analysis with adjustment for pre-arrest patient condition and arrest variables, survival rate did not differ significantly between the two groups. However, the good neurologic outcomes showed an association with the emergency physician team. CONCLUSION: For in-hospital cardiac arrest, outcomes for patients who were rescued by the emergency physician-directing CPR team might be comparable or better, compared with those by the non-emergency physician team.

Clinical Analysis of CPR in Infants with Out-of-Hospital Cardiopulmonary Arrest

PURPOSE: Since 1960 pediatric advanced life support (PALS) has been studied and applied to clinical situations, ILCOR guidelines 2000 for CPR and ECC was achieved. Pediatric cardiopulmonary arrest differs from adult arrest in etiologies, mechanisms, and managements. This study was performed to identify the clinical manifestations and real picutre of CPR to recognize the need of standard CPR method that increases the survival in infants with out-of hospital arrest. METHODS: This study was planned by retrospectively reviewed the records of all children who arrived without spontaneous respiration and palpable pulse at the emergency room of the three Hospitals from January 1996 to July 2003. RESULTS: During that period, 45 infants presented with out of-hospital cardiopulmonary arrest. Overall, there was a return of vital signs in 15 of the 45 patients; 6 survived to discharge from hospital. 1. Out-of-hospital arrest in infants demonstrated that 60% were male, mean age was 133.4 days. Of these, 71.1% of the arrests occurred in the home with family members presents, those family members didn't perform basic CPR in only 1 case. 2. In any ROSC group, the interval between the arrest and arrival at the hospital was 14.4 minutes. In ROSC never achieved group, the interval was 32.0 minutes. 3. Two of the 15 patients with SIDS(13.3%) and four of the 13 patients with respiratory arrest(30.8%) survived to hospital discharge. CONCLUSION: Factors that predicted survival to discharged alive included a death caused by respiratory disease, a short interval between the arrest and arrival at the hospital, and a short duration of resuscitation efforts in the ER. We found that need of standard guideline and commonly applied CPR techniques.