In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines

Boyde, Mary S., Padget, Michelle, Burmeister, Elizabeth and Aitken, Leanne M. (2013) In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines. Australian Health Review, 37 2: 178-184. doi:10.1071/AH11112


Author Boyde, Mary S.
Padget, Michelle
Burmeister, Elizabeth
Aitken, Leanne M.
Title In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
1449-8944
Publication date 2013-04-09
Sub-type Article (original research)
DOI 10.1071/AH11112
Open Access Status Not yet assessed
Volume 37
Issue 2
Start page 178
End page 184
Total pages 7
Place of publication Clayton, VIC, Australia
Publisher CSIRO Publishing
Language eng
Formatted abstract
Objective To evaluate cardiac arrest outcomes following the introduction of the Australian Resuscitation Council (ARC) 2006 amended guidelines for basic and advanced life support.
Methods A retrospective study of all consecutive cardiac arrests during a 3-year phase pre-implementation (2004-06) and a 3-year phase post-implementation (2007-09) of the ARC 2006 guidelines was conducted at a tertiary referral hospital in Brisbane, Australia.
Results Over the 6-year study phase 690 cardiac arrests were reported. Resuscitation was attempted in 248 patients pre-implementation and 271 patients post-implementation of the ARC 2006 guidelines. After adjusting for significant prognostic factors we found no significant change in return of spontaneous circulation (ROSC) (odds ratio 1.21, 95% confidence interval 0.80-1.85, P≤0.37) or survival to discharge (odds ratio 1.49, 95% confidence interval 0.94-2.37, P≤0.09) after the implementation of the ARC 2006 guidelines. Factors that remained significant in the final model for both outcomes included having an initial shockable rhythm, a shorter length of time from collapse to arrival of cardiac arrest team, location of the patient in a critical-care area, shorter length of resuscitation and a day-time arrest (0700-2259hours). In addition the arrest being witnessed was significant for ROSC and younger age was significant for survival to discharge.
Conclusions There are multiple factors that influence clinical outcomes following an in-hospital cardiac arrest and further research to refine these significant variables will assist in the future management of cardiac arrests.
What is known about this topic? The evaluation of outcomes from in-hospital cardiac arrests focuses on immediate survival expressed as ROSC and survival to hospital discharge. These clinical outcomes have not improved substantially over the last two decades.
What does this paper add? This paper identifies the factors that are related to ROSC and survival to discharge following the implementation of the ARC 2006 guidelines, which included a refocus on providing quality cardiopulmonary resuscitation with minimal interruptions.
What are the implications for practitioners? Given that multiple factors can influence clinical outcomes following an in-hospital cardiac arrest, focusing on maximising a range of factors surrounding cardiopulmonary resuscitation is essential to improve outcomes.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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