[In-hospital resuscitation concept with first-responder defibrillation. 2-year experience].
OBJECTIVE
Sudden cardiac arrest appears in 1-5 patients/ 1,000 clinical admissions. In spite of different research approaches, the prognosis after in-hospital resuscitation has not significantly improved in the last 40 years. This account presents the experiences with a hospital-wide emergency plan using the concept of defibrillation by first responders.


METHODS
In 2003, a hospital-wide emergency plan was implemented. The concept comprised the setup of 15 "defibrillator points", training of the entire hospital personnel as first responder, and the introduction of an emergency team. Over the following 3 years, the concept was optimized. In a period from May 2006 to April 2008, the data of all patients who received an in-hospital resuscitation were collected.


RESULTS
Within 24 months, a total of 41 resuscitations were conducted. Out of these, 24 patients (58%) were under intensive monitoring when the event occurred. Initially, 15 patients (36%) showed ventricular fibrillation, 15 (36%) a pulseless electrical activity, and eleven (27%) an asystoly. A total of twelve patients (29%) left hospital alive. About half of them (42%) experienced ventricular fibrillation and were under observation at the time of event.


CONCLUSIONS
The data collected since the implementation of the hospital- wide emergency plan in 2003 reflect the daily clinical routine. The results show that there is a better outcome especially in patients with ventricular fibrillation when receiving first-responder defibrillation.
Robert
Nils
N
Innere Klinik II/Kardiologie, Katharinen-Hospital Unna, Unna, Germany.
Kloppe
Cordula
C
Mügge
Andreas
A
Hanefeld
Christoph
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D004554:Electric Countershock / Q000379:methods* / Q000401:mortality; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005858:Germany; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D014693:Ventricular Fibrillation / Q000401:mortality / Q000628:therapy*