title: [In-hospital resuscitation--definitely better than in the field?].
abstract: Despite favorable conditions, in-hospital resuscitations do not lead to higher survival rates than those in the field. Recent studies show an average survival rate of 18%. One of the most important predictors for an unfavorable survival is a delay of defibrillation of greater than 2 minutes, which leads to a reduction of ROSC, 24-hour survival and survival to discharge. With respect to the guidelines of the European Resuscitation Council for cardiopulmonary resuscitation from 2010, track and trigger systems to detect the deteriorating patient should be used. Of note, the survival rate for in-hospital resuscitation is significantly lower over the weekend and at night than on workdays and during the day--most likely because fewer staff is available. More than 80% of patients with an unexpected cardiac arrest exhibit cardiopulmonary and neurological abnormalities prior to this event. A Medical Emergency Teams (MET) could intervene in such cases and thus decrease the likelihood of cardiac arrest. METs are more time-consuming and more labor-intensive than simple resuscitation teams, but these resources are well spent, as unexpected admissions to the intensive care unit can be avoided and patients receive treatment before their conditions deteriorate. Hospitals should therefore analyze and evaluate their internal emergency response plans.
authors.affiliation: UniversitätsklinikumSchleswig-Holstein,Campus Kiel, Klinik für Anästhesiologie und Operative Intensivmedizin. graesner@anaesthesie.uni-kiel.de
authors.forename: Jan-Thorsten
authors.initials: JT
authors.lastname: Gräsner
authors.forename: André
authors.initials: A
authors.lastname: Gries
authors.forename: Berthold
authors.initials: B
authors.lastname: Bein
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Tanja
authors.initials: T
authors.lastname: Jantzen
authors.forename: Michael
authors.initials: M
authors.lastname: Bernhard
mesh_terms: D000761:Anesthesia Department, Hospital; D016208:Databases, Factual; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004554:Electric Countershock; D004632:Emergency Medical Services; D005858:Germany / Q000453:epidemiology; D017408:Guidelines as Topic; D057209:Hospital Rapid Response Team; D006760:Hospitalization; D006801:Humans; D012042:Registries; D012151:Resuscitation / Q000592:standards*; D016414:Resuscitation Orders; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology