CPR in Siriraj Hospital: A preliminary report.

ABSTRACT

The determine the incidence and outcome of cardiopulmonary resuscitation (CPR), the availability of CPR equipments and personnel competence, we did a retrospective study by asking the head nurses of 117 wards in Siriraj Hospital. These were 53 adult wards, 24 pediatric wards and 40 combined wards. The total amount of patients in 3-month period was 183,874 patients which included 34,116 in-patients and 149,758 out-patients. Cardiac arrest occurred in 694 in-patients (2.03% of total patients) and 54 out-patients (0.04% of total patients). Among the 748 cardiac arrest patients, 685 received CPR (91.58% of cardiac arrest patients). Among these patients, 292 responded to CPR (42.67% of patients received CPR) and 393 died in spited of CPR (57.37% of patients received CPR). Patients in the Department of Internal Medicine had the highest incidence of CPR (47% of patients received CPR) whereas those in the Department of Radiology, Ophthalmology, Otorhinolaryngology had the lowest incidence (1%). The survival rates following CPR in the aforementioned departments were 32%, 0% and 20% respectively. Defibrillators were available in 24% of the wards. The completeness of airway equipments ranged from 60% to 90% of the wards. Electrocardiography, pulse oximeter and capnometry were available in 50%, 18% and 7% of the wards respectively. Subjective evaluation of nurses competence in performing CPR were as following 86% of nurses from ICU were able to perform basic life support compare to 55% of nurses from emergency room and 31% of nurses from general wards. Fifty-five to sixty-two percent of ICU nurses could interpret ECG monitoring and 61% of nurses from 8 ICUs could used defibrillators. Delay time in doctor’s arrival for CPR more than 10 minutes was found in 54% of the wards. In order to improve the efficiency of CPR, we suggest that teaching and training of CPR should be mandatory and continuous, the guideline of CPR equipments should be recommended by the hospital’s experts and the hospital should provide more defibrillators to wards. The administration and communication system s should be reorganized to reduce the delay time in CPR.