Monangi Srinivas, Setlur Rangraj, Ramanathan Ramprasad, Bhasin Sidharth, Dhar Mridul
Department of Anaesthesiology and Critical Care, Army Hospital (Research and Referral), New Delhi, India.
Saudi J Anaesth. 2018 Apr-Jun;12(2):245-249. doi: 10.4103/sja.SJA_613_17.
"Code blue" (CB) is a popular hospital emergency code, which is used by hospitals to alert their emergency response team of any cardiorespiratory arrest. The factors affecting the outcomes of emergencies are related to both the patient and the nature of the event. The primary objective was to analyze the survival rate and factors associated with survival and also practical problems related to functioning of a CB system (CBS).
After the approval of hospital ethics committee, an analysis and audit was conducted of all patients on whom a CB had been called in our tertiary care hospital over 24 months. Data collected were demographic data, diagnosis, time of cardiac arrest and activation of CBS, time taken by CBS to reach the patient, presenting rhythm on arrival of CB team, details of cardiopulmonary resuscitation (CPR) such as duration and drugs given, and finally, events and outcomes. Chi-square test and logistic regression analysis were used to analyze the data.
A total of 720 CB calls were initiated during the period. After excluding 24 patients, 694 calls were studied and analyzed. Six hundred and twenty were true calls and 74 were falls calls. Of the 620, 422 were cardiac arrests and 198 were medical emergencies. Overall survival was 26%. Survival in patients with cardiac arrests was 11.13%. Factors such as age, presenting rhythm, and duration of CPR were found to have a significant effect on survival. Problems encountered were personnel and equipment related.
A CBS is effective in improving the resuscitation efforts and survival rates after inhospital cardiac arrests. Age, presenting rhythm at the time of arrest, and duration of CPR have significant effect on survival of the patient after a cardiac arrest. Technical and staff-related problems need to be considered and improved upon.
“蓝色急救代码”（CB）是医院常用的紧急代码，医院用它提醒应急反应团队有任何心肺骤停情况。影响紧急情况结果的因素与患者和事件性质都有关。主要目的是分析生存率及与生存相关的因素，以及与CB系统（CBS）运行相关的实际问题。
经医院伦理委员会批准，对我院24个月内所有呼叫过CB的患者进行了分析和审核。收集的数据有人口统计学数据、诊断、心脏骤停时间和CBS启动时间、CBS到达患者所用时间、CB团队到达时的初始心律、心肺复苏（CPR）的详细情况（如持续时间和所用药物），最后是事件和结果。采用卡方检验和逻辑回归分析来分析数据。
在此期间共发起720次CB呼叫。排除24例患者后，对694次呼叫进行了研究和分析。其中620次是真实呼叫，74次是误报。在620次真实呼叫中，422次是心脏骤停，198次是医疗紧急情况。总体生存率为26%。心脏骤停患者的生存率为11.13%。发现年龄、初始心律和CPR持续时间等因素对生存有显著影响。遇到的问题与人员和设备有关。
CBS在提高院内心脏骤停后的复苏努力和生存率方面是有效的。年龄、心脏骤停时的初始心律和CPR持续时间对心脏骤停后患者的生存有显著影响。需要考虑并改进与技术和人员相关的问题。
