WASHINGTON, May 10 A simple procedural change may significantly reduce cardiopulmonary arrests outside a pediatric hospital's intensive care unit, according to a study reported at the American Heart Association's 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
Cardiac arrests outside the Pediatric Intensive Care Unit (PICU) at Children's Medical Center Dallas dropped by 63 percent after doctors and nurses changed procedures to call the cardiac emergency team or Code Blue Team, whenever warning signs indicated a patient's lungs or heart might stop working. Previously, staff summoned the team only after starting cardiopulmonary resuscitation (CPR) after a cardiac arrest.
"Our goal was to get patients moved to the PICU and a higher level of care sooner, hoping to prevent an arrest," said Tia A. Tortoriello, M.D., senior author of the study, assistant professor of pediatrics in the Division of Cardiology at University of Texas Southwestern Medical Center at Dallas and medical staff member at Children's Medical Center Dallas. "And if we couldn't prevent it, the arrest could be better controlled in the PICU."
Cardiac arrest is different in children than in adults. In adults, heart stoppages mostly result from a heart attack or electric malfunction of the heart. Children rarely have a primary cardiac arrest. Most often, their arrests evolve from respiratory problems, researchers said.
Tortoriello joined the 411-bed hospital's CPR Committee as co-chair in late 2003. She became convinced that the data it had collected could lead to better ways to reduce the number of patients who suffered a full cardiac arrest outside the PICU.
Tortoriello credits the American Heart Association's National Registry of Cardiopulmonary Resuscitation (NRCPR) with enabling Children's Medical Center to shift its response focus from reaction and resuscitation to earlier intervention and prevention.