Emergency medicine residents effectively direct inhospital cardiac arrest teams.
OBJECTIVE
We compared 2 models of physician leadership for inhospital cardiac arrest teams (CATs): emergency medicine (EM) residents and staff hospitalist physicians.


METHODS
A before-after study was conducted on all adult inhospital CAT activations over a 2-year period. The primary outcome was return of spontaneous circulation (ROSC).


RESULTS
There were 749 total code blues during the 2-year study period. Ninety-one were excluded by protocol. EM residents directed 288 codes, hospitalists directed 248 codes, and other specialties directed the remaining 62. There was no statistically significant difference in percent ROSC or survival to hospital discharge. EM residents responded first for 59.2% of the codes compared with a first response rate of 28% for hospitalists (P<.05). Time to achieve ROSC was quicker in the EM resident cohort.


CONCLUSIONS
Our findings validate the use of a 24-hour EM resident staffing model for CAT response to inhospital cardiac arrests.
Adams
Bruce D
BD
Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, TX 78234-6200, USA. bruce.adams@amedd.army.mil
Zeiler
Kathy
K
Jackson
Walter O
WO
Hughes
Brian
B
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007396:Internship and Residency; D007857:Leadership; D008297:Male; D008511:Medicine; D010348:Patient Care Team / Q000458:organization & administration; D013038:Specialization