A survey of the in-hospital response to cardiac arrest on general wards in the hospitals of Rome.
OBJECTIVE
To investigate the response to cardiac arrest in general wards.


METHODS
Direct interview with the cardiac arrest team (CAT) members in 32 hospitals in Rome, Italy.


RESULTS
The majority of CATs are activated by telephone but only two (6%) hospitals have a dedicated telephone number for emergency calls. The CAT always includes a physician, who is usually an anaesthesiologist (30 hospitals, 94%), and usually includes one or two other members (23 hospitals, 72%). In 21 hospitals (65%) there is less than one defibrillator per floor but in only six hospitals (19%), CATs are equipped with defibrillators. Resuscitation guidelines are adopted by 15 teams (47%). The Utstein style of data collection is used in only one hospital. The most common problems reported by the CATs are: insufficient training of ward personnel (29 hospitals, 91%), insufficient staff (19 hospitals, 59%) and insufficient equipment (18 hospitals, 56%). Average maximum arrival time for the CAT to arrive is 220 s, but varies significantly between single-building and the multiple-building hospitals (88 vs. 390 s; P<0.001).


CONCLUSIONS
The majority of the cardiac arrest teams have acceptable response times, but their efficiency may be impaired by the lack of staff, equipment and co-ordination with the ward personnel. CAT members identified a strong need for BLS training of ward personnel. More widespread introduction of standard protocols for resuscitation and reporting of cardiac arrest are necessary to evaluate aspects that may need improvement.
Sandroni
Claudio
C
Department of Anaesthesiology and Intensive Care, Largo Agostino Gemelli 8, 00168, Rome, Italy. sandroni@rm.unicatt.it
Cavallaro
Fabio
F
Ferro
Giorgia
G
Fenici
Peter
P
Santangelo
Susanna
S
Tortora
Francesca
F
Conti
Giorgio
G
D003625:Data Collection; D004526:Efficiency; D004554:Electric Countershock / Q000295:instrumentation; D004631:Emergency Medical Service Communication Systems; D004636:Emergency Service, Hospital / Q000592:standards*; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007407:Interviews as Topic; D010362:Patients' Rooms; D012151:Resuscitation / Q000592:standards; D012384:Rome; D013689:Telephone