Authors (including presenting author) :
WM Chan (1), LF Hui (2), ML Tang (2), S K Fok (2), W M Ng (2), K S Tang (2)
Affiliation :
(1) Adult Intensive Care Unit, Queen Mary Hospital (2) Department of Quality and Safety, Queen Mary Hospital
Introduction :
There is a complicated system of calling doctors to respond to cardiopulmonary resuscitation (CPR) in Queen Mary Hospital for adults. Doctors from the Parent Specialty, Adult Intensive Care Unit or Department of Anesthesiology might be called, depending on the location of arrest and the Parent Specialty of the patients. There are geographical and access issues in that the K Block is rather distant from the Main Block. The need to wait for lift transport to the higher floors of K Block is a concern.
Objectives :
-To evaluate CPR outcome for adult in-patients who received CPR.
-To determine factors affecting the CPR outcome.
Methodology :
The standard CPR records of adult in-patients who received CPR from 1/1/2017 to 31/12/2018 were retrospectively reviewed.
The related factors such as gender, age, location of cardiac arrest, response time, time of day, day of week, witnessed arrest, central resuscitation team (CRT) involvement, resident arrival time greater than 3 minutes were analyzed. 30-day (D30) survival was the primary outcome measure.
Result & Outcome :
A total of 602 records were analyzed. The immediate survival rate was 58.3% but the crude D30 survival rate was 8.1%. 78.1% of cardiac arrest were witnessed. The relation between D30 survival and witnessed cardiac arrest was significant (X2=9.88, p=0.002). Overall, 14.8% of cardiac arrests occurred in K Block. The percentage of D30 survival in K Block and Main Block was 15.7% and 6.9 % respectively. It showed significantly different (X2=8.24, p=0.005). This had not been adjusted for difference in case mix of two buildings. The CRT was involved in 29.1% of CPR. There was no difference of D30 survival between CRT (10.3%) and parent team (7.3%) (X2=1.52, p=0.218). In 6.1% of CPR calls, the Resident arrived later than 3 minutes after being called. There was no D30 survivor in this subgroup. Residents arrived earlier in the group of D30 survival was 8.7%. There was no statistically different between D30 survival and whether or not Resident arrival ≤ 3 minutes (p=0.062). D30 survival was independent of the time slot of arrest during the day (X2=0.05, p=0.943) and whether the arrest occurred in weekends versus weekdays (X2=4.342, p=0.114). When multiple logistic regression was performed, only age, witnessed arrest and location of arrest were correlated with D30 survival. Conclusion A regular review of CPR records is useful in reassuring the practicality and safety of a complicated infrastructure of call for resuscitation.
