The sounds of cardiac arrest: innovating to obtain an accurate record during in-hospital cardiac arrest.
BACKGROUND
To obtain an accurate audit during in-hospital cardiac arrest, following recommendations of the Utstein style and measuring time intervals between the different interventions, is difficult.


OBJECTIVE
To assess whether the use of an audio recording system during in-hospital cardiac arrest resuscitation allows the register of more items during cardiopulmonary resuscitation.


METHODS
Prospective observational study between January 2008 and December 2009. The population that were included, were hospitalized patients and non-hospitalized patients assisted by a cardiac arrest team, except for critical areas. An audio recording system with a timer was turned on when cardiac arrest team was alerted. Recordings were reviewed to fill in the items recommended by the Utstein style. Time intervals were calculated. Mean number of completed items per patient were compared between recorded and non-recorded cardiac arrest.


RESULTS
119 CA team alerts took place. 64 (53.7%) cases were real CA and 37 (57.8%) of them were properly recorded. A mean number of items per patient in recorded cardiac arrest cases were 18.18 (±3.2) vs. 15.96 (±4.1) in non-recorded cardiac arrest cases (p<0.05). In the recorded cases, mean times were: alert - arrival: 1.23 (±0.95)min; arrival - cardiopulmonary resuscitation initiation: 0.63 (±0.38)min; arrival - first defibrillation: 2.06 (±1.33)min; arrival - intubation: 8.42 (±4.64)min; arrival - first adrenaline: 3.30 (±1.98)min.


CONCLUSIONS
The audio recording system permits the register of a larger number of items per patient during in-hospital cardiac arrest and allows measurement of time intervals between the different interventions during cardiopulmonary resuscitation.
Critical Care Department, Vall d'Hebron University Hospital, Research Group in Shock, Multiorgan Dysfunction and Resuscitation, Vall d' Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain. nuduma@hotmail.com
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N
Duran
J
J
Riera
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Nuvials
J C
JC
Ruiz-Rodriguez
J
J
Serra
J
J
Rello
D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D011446:Prospective Studies; D013637:Tape Recording