foodconsumer.org: Timing of cardiac arrest critical for optimal care

Timing of cardiac arrest critical for optimal care
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admin on 06/27/2009 16:38:00
 
Researchers have found that people who have a cardiac arrest in the hospital at
night or on the weekends are more likely to die than at other times, probably
due at least partially to inadequate staffing at off-peak hours, Reuters
reported.
The study, reported in the Journal of the American Medical Association, showed
only 14.7 percent of people would survive sudden cardiac arrest in the hospital
at night or on the weekend compared to about 20 percent of people during the
day.
Dr. Mary Ann Peberdy of Virginia Commonwealth University in Richmond and
colleagues said the survival difference by time of day was apparent anywhere in
the hospital except in the emergency room.
Peberdy explained that emergency departments are often the only place in
hospitals where senior-level physicians are often available.
When cardiac arrest occurs, the blood stops circulating, causing massive deaths
of cells and eventually death of the patient.  Survival is likely impossible if
the patient cannot be resuscitated within minutes.
A small percent of patients who suffer cardiac arrest may be saved after treated
with cardiopulmonary resuscitation or CPR and often a shock from a
defibrillator.
The study showed staffing played a role in survival rates.
But other studies, according to Reuters, have showed that doctors are more prone
to making more mistakes at night, which would reduce the survival odds.
Another study, reported by foodconsumer.org reported on Jan 3, 2008, suggested
that as many as 25,000 people die from sudden cardiac arrest each year mainly
because the staff in hospital responds too slowly.  The results were published
in the New England Journal of Medicine.
That study was conducted by Dr. Paul S. Chan, of St. Luke's Mid-America Heart
Institute in Kansas City, and the University of Michigan. It found many
hospitals did not follow the guideline to help patients within two minutes of a
cardiac arrest.
As a result, delayed response saved only 22.2 percent of patients who suffered
cardiac arrest compared to 39 percent of patients who received prompt
resuscitation procedures.
According to the New York Times, automatic defibrillators are cheap, readily
available and easy to use for even laymen.
Dr. Leslie A. Saxon, chief of cardiology at the University of Southern
California, suggested in an editorial accompanying Chan's study paper that
hospitals are not the best place to have cardiac arrest and hospitals should use
more defibrillators if more sophisticated measures are not readily available.
In the current study, Peberdy and team looked at data from the National Registry
of Cardiopulmonary Resuscitation on 86,000 adults who had heart attacks in more
than 500 hospitals between January 2000 and February 2007.
For the study, researchers defined the day/evening as 7 a.m. to 10:59 p.m.,
night as 11 p.m. to 6:59 a.m. and weekends as the period from 11 p.m. Friday
through 6:59 a.m. Monday.
Peberdy told Reuters through a phone interview that the time effect was
significant even with other risk factors such as severity of illness and
patients' initial heart rhythms.
The results of Peberdy's study suggested that hospitals need to improve their
service to increase the survival odds for cardiac arrest patients during nights
and weekends.
In the United States, 370,000 to 750,000 people suffer sudden cardiac arrest
each year and only less than one third survive.
(Written by foodconsumer.org and edited by Sheilah Downey)