Department of Emergency Medicine, Marmara University Pendik Research and Training Hospital, 34890, Istanbul, Turkey.
World J Emerg Med. 2014;5(1):20-3. doi: 10.5847/wjem.j.issn.1920-8642.2014.01.003.
Cardiac arrests in hospital areas are common, and hospitals have rapid response teams or "blue code teams" to reduce preventable in-hospital deaths. Education about the rapid response team has been provided in all hospitals in Turkey, but true "blue code" activation is rare, and it is abused by medical personnel in practice. This study aimed to determine the cases of wrong blue codes and reasons of misuse.
This retrospective study analyzed the blue code reports issued by our hospital between January 1 and June 1 2012. A total of 89 "blue code" activations were recorded in 5 months. A "blue code" was defined as any patient with an unexpected cardiac or respiratory arrest requiring resuscitation and activation of a hospital alert. Adherence to this definition, each physician classified their collected activation forms as either a true or a wrong code. Then, patient data entered a database (Microsoft Excel 2007 software) which was pooled for analysis. The data were analyzed by using frequencies and the Chi-square test on SPSSv16.0.
The patients were diagnosed with cardiopulmonary arrest (8), change in mental status (18), presyncope (11), chest pain (12), conversive disorder (18), and worry of the staff for the patient (22). Code activation was done by physicians in 76% of the patients; the most common reason for blue code was concern of staff for the patient.
The findings of this study show that more research is needed to establish the overall effectiveness and optimal implementation of blue code teams.
医院区域内的心脏骤停很常见，医院有快速反应团队或“蓝码团队”，以减少可预防的院内死亡。土耳其所有医院都提供了有关快速反应团队的教育，但真正的“蓝码”激活很少见，并且在实践中被医务人员滥用。本研究旨在确定错误蓝码的案例和滥用的原因。
本回顾性研究分析了我们医院 2012 年 1 月 1 日至 6 月 1 日期间发布的蓝码报告。在 5 个月内记录了 89 次“蓝码”激活。“蓝码”被定义为任何需要复苏和激活医院警报的突发心脏或呼吸骤停的患者。根据这一定义，每位医生将他们收集的激活表分类为真码或错码。然后，患者数据输入 Microsoft Excel 2007 软件数据库进行分析。使用 SPSSv16.0 对数据进行频率和卡方检验分析。
患者被诊断为心肺骤停（8 例）、精神状态改变（18 例）、晕厥前状态（11 例）、胸痛（12 例）、转换障碍（18 例）和工作人员对患者的担忧（22 例）。医生在 76%的患者中进行了代码激活；蓝码最常见的原因是工作人员对患者的担忧。
本研究的结果表明，需要进一步研究以确定蓝码团队的整体效果和最佳实施。
