Department of Critical Care, SPS Apollo Hospitals, Sherpur Chowk, Ludhiana, 141003, Punjab, India,
J Anesth. 2015 Feb;29(1):87-95. doi: 10.1007/s00540-014-1873-z. Epub 2014 Jul 4.
Despite advances in cardiopulmonary resuscitation and widespread life-support trainings, the outcomes of resuscitation are variable. There is a definitive need for organizational inputs to strengthen the resuscitation process. Our hospital authorities introduced certain changes at the organizational level in our in-house resuscitation protocol. We aimed to study the impact of these changes on the outcomes of resuscitation.
The hospital code blue committee decided to reformulate the resuscitation protocols and reframe the code blue team. Various initiatives were taken in the form of infrastructural changes, procurement of equipment, organising certified training programs, conduct of mock code and simulation drills etc. A prospective and retrospective observational study was made over 6 years: a pre-intervention period, which included all cardiac arrests from January 2007 to December 2009, before the implementation of the program, and a post-intervention period from January 2010 to December 2012, after the implementation of the program. The outcomes of interest were response time, immediate survival, day/night survival and survival to discharge ratio.
2,164 in-hospital cardiac arrests were included in the study, 1,042 during the pre-intervention period and 1,122 during the post-intervention period. The survival percentage increased from 26.7 to 40.8 % (p < 0.05), and the survival to discharge ratio increased from 23.4 to 66.6 % (p < 0.05). Both day- and night-time survival improved (p < 0.05) and response time improved from 4 to 1.5 min.
A strong hospital-based resuscitation policy with well-defined protocols and infrastructure has potential synergistic effect and plays a big role in improving the outcomes of resuscitation.
尽管心肺复苏术和广泛的生命支持培训取得了进展，但复苏的结果仍存在差异。确实需要组织投入来加强复苏过程。我们医院管理部门在内部复苏方案的组织层面上进行了某些更改。我们旨在研究这些更改对复苏结果的影响。
医院的蓝色代码委员会决定重新制定复苏方案并重新制定蓝色代码团队。通过基础设施变更、设备采购、组织认证培训计划、进行模拟代码和模拟演练等形式采取了各种举措。进行了为期 6 年的前瞻性和回顾性观察研究：干预前期间，包括 2007 年 1 月至 2009 年 12 月实施该方案之前的所有心脏骤停，以及干预后期间，即 2010 年 1 月至 2012 年 12 月实施该方案之后。感兴趣的结果是响应时间、即刻存活率、白天/夜间存活率和出院存活率。
共有 2164 例院内心脏骤停纳入研究，干预前期间 1042 例，干预后期间 1122 例。存活率从 26.7%增加到 40.8%（p<0.05），出院存活率从 23.4%增加到 66.6%（p<0.05）。白天和夜间的存活率均有所提高（p<0.05），反应时间从 4 分钟提高到 1.5 分钟。
具有明确协议和基础设施的强大医院基础复苏政策具有潜在协同作用，对改善复苏结果起着重要作用。
