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Objective: To survey the times to critical actions (defibrillator and doctor presence, initiation of chest compression) of inhospital
simulated cardiopulmonary resuscitation (CPR).
Methods: A 1-year retrospective simulated audit 2009 in a 2,400-bed university hospital in Thailand.
Results: A total of 57 adult wards (around a third of all wards in the hospital), including intensive care units, critical wards,
procedural units, general wards and out-patient units were audited. Overall, the median time of initiation of chest compression
and defibrillator presence among CPR teams were 1.27 (0.35-7.19) and 1.16 (0.00-26.00) minutes, respectively. The median
time of the first doctor presence was 3.45 (0.00-15.15) minutes. However, there were significant differences in time to defibrillator
and doctor presence among wards. The longer time of these critical managements were recorded in non-monitored areas
(general wards and out-patient units) (p = 0.004 and 0.007, respectively).
Conclusion: In our CPR simulated survey, delayed initiation of critical managements commonly occurred in non-monitored
areas. Better management should be concerned for favorable outcomes.
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et al. Part 4: CPR overview: 2010 American Heart Association Guidelines
for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Circulation. 2010 Nov 2;122(18 Suppl 3):S676-84.
2. Seethala RR, Esposito EC, Abella BS. Approaches to improving cardiac
arrest resuscitation performance. Curr Opin Crit Care. 2010 Jun;16(3):196-
3. Fredriksson M, Aune S, Bång A, Thorén Ann-Britt, Lindqvist J, Karlsson T,
et al. Cardiac arrest outside and inside hospital in a community: Mechanisms
behind the differences in outcome and outcome in relation to time
of arrest. Am Heart J. 2010 May;159(5):749-56.
4. Mhyre JM, Ramachandran SK, Kheterpal S, Michelle Morris M, Chan
PS. Delayed Time to Defi brillation after Intraoperative and Periprocedural
Cardiac Arrest. Anesthesiology. 2010 Oct;113(4):782-93.
5. Chan PS, Krumholz HM, Nichol G, Nallamothu BK. American Heart
Association National Registry of Cardiopulmonary Resuscitation Investigators.
Delayed time to defi brillation after in-hospital cardiac arrest. N
Engl J Med. 2008 Jan; 358(1):9-17.
6. Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest:
incidence, prognosis and possible measures to improve survival. Intensive
Care Med. 2007 Feb;33(2):237-45.
7. Herlitz J, Aune S, Bång A, Fredriksson M, Thorén AB, Ekström L, et al.
Very high survival among patients defi brillated at an early stage after
in-hospital ventricular fi brillation on wards with and without monitoring
facilities. Resuscitation. 2005 Aug;66(2):159-66.
8. Krittayaphong R, Saengsung P, Chawaruechai T, Yindeengam A, Udompunturak
S. Factors Predicting Outcome of Cardiopulmonary Resuscitation
in a Developing Country: The Siriraj Cardiopulmonary Resuscitation
Registry. J Med Assoc Thai 2009 May;92(5):618-23.
9. Suraseranivongse S, Chawaruechai T, Saengsung P, Komoltri C. Outcome
of cardiopulmonary resuscitation in a 2300-bed hospital in a developing
country. Resuscitation. 2006 Nov;71(2):188-93.
10. Sandroni C, Ferro G, Santangelo S, Tortora F, Mistura L, Cavallaro F,
et al. In-hospital cardiac arrest: survival depends mainly on the effectiveness
of the emergency response. Resuscitation. 2004 Sep;62(3):291-7.
11. Campbell JP, Maxey VA, Watson WA. Hawthorne effect: implications
for prehospital research. Ann Emerg Med. 1995 Nov;26(5):590-4.