title: The emergency cardiac arrest response team (eCART): a novel strategy for improving therapeutic hypothermia utilization following out-of-hospital cardiac arrest.
abstract: BACKGROUND
  Out-of hospital cardiac arrest (OHCA) is associated with significant mortality. Therapeutic hypothermia is one of the few interventions that have been shown to increase post-arrest survival as well as enhance neurologic recovery. Despite clinical guidelines recommending the use of therapeutic hypothermia (TH) following cardiac arrest, utilization rates by physicians remain low. We hypothesized that the development of a multi-disciplinary emergency cardiac arrest response team (eCART) would enhance therapeutic hypothermia utilization in the emergency department for OHCA.
  
  
  RESULTS
  An eCART (emergency department cardiac arrest response team) was created at a single site academic urban emergency department. The eCART team consisted of a physician hypothermia consultant, a cardiologist, a clinical pharmacist, a respiratory therapist and a chaplain. These providers were notified by page prior to the arrival of an OHCA patient and responded to the ED in person or by phone to support the resuscitation. Analysis of pre- and post-intervention data demonstrated a significant increase in the rate of TH utilization (64% to 96%). There was a non-significant decrease in the time to target temperature.
  
  
  CONCLUSIONS
  The creation of a coordinated, multi-disciplinary care team, providing real-time support for OHCA patients increased TH utilization in an emergency department.
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Deal
authors.forename: Willard W
authors.initials: WW
authors.lastname: Sharp
authors.forename: Gerasim A
authors.initials: GA
authors.lastname: Orbelyan
authors.forename: Meredith H
authors.initials: MH
authors.lastname: Borak
authors.forename: Janet
authors.initials: J
authors.lastname: Friant
authors.forename: Atman P
authors.initials: AP
authors.lastname: Shah
authors.forename: David G
authors.initials: DG
authors.lastname: Beiser
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D010348:Patient Care Team / Q000592:standards*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies