Impact of a COVID-19 code blue protocol on resuscitation care and CPR quality during in-hospital cardiac arrest.
Resuscitation
; 198: 110172, 2024 May.
Article
en En
| MEDLINE
| ID: mdl-38461888
ABSTRACT
OBJECTIVE:
We sought to evaluate the impact of a COVID-19 Code Blue policy on in-hospital cardiac arrest (IHCA) processes of care, cardiopulmonary resuscitation (CPR) quality metrics, and survival to hospital discharge.METHODS:
We completed a health record review of consecutive IHCA for which resuscitation was attempted. We report Utstein outcomes and CPR quality metrics 33 months before (July,2017-March,2020) and after (April,2020-December,2022) the implementation of a COVID-19 Code Blue policy requiring all team members to don personal protective equipment including gown, gloves, mask, and eye protection for all IHCA.RESULTS:
There were 800 IHCA with the following characteristics (Before n = 396; After n = 404) mean age 66, 62.9% male, 81.3% witnessed, 31.3% in the emergency department, 25.6% cardiac cause, and initial shockable rhythm in 16.7%. Among all 404 patients screened for COVID-19, 25 of 288 available test results before IHCA occurred were positive. Comparing the before and after periods there were relevant time delays (minsec) in start of chest compressions (017vs.037;p = 0.005), team arrival (043vs.121;p = 0.002), 1st rhythm analysis (115vs.316;p < 0.0001), 1st epinephrine (344vs.434;p = 0.02), and airway insertion (838vs. 1018;p = 0.02). Resuscitation duration was similar (1828vs.1935;p = 0.34). Exception of peri-shock pause which appeared longer (006vs.014;p = 0.07), chest compression fraction, rate and depth were identical and good. Factors independently associated with survival were age (adjOR 0.98;p < 0.001), male sex (adjOR 1.51;p = 0.048), witnessed (adjOR 2.35;p = 0.02), shockable rhythm (adjOR 3.31;p < 0.0001), hospital location (p = 0.0002), and COVID-19 period (adjOR 0.68;p = 0.052).CONCLUSIONS:
The COVID-19 Code Blue policy was associated with delayed processes of care but similarly good CPR quality. The COVID-19 period appeared associated with decreased survival.Palabras clave
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Base de datos:
MEDLINE
Asunto principal:
Reanimación Cardiopulmonar
/
COVID-19
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Paro Cardíaco
Idioma:
En
Revista:
Resuscitation
Año:
2024
Tipo del documento:
Article