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AHA Calls for Changes in Hospital Cardiac-Arrest Care

Statement offers recommendations to improve survival (Mar. 11)

Policy and practice changes by health care institutions, providers, and others could greatly improve medical care and improve survival for people who have a sudden cardiac arrest in the hospital, according to an American Heart Association (AHA) consensus statement published in its journal, Circulation.

Each year, more than 200,000 adults and 6,000 children experience in-hospital cardiac arrests, and survival has remained essentially unchanged for decades, the statement says. According to the AHA, only 24% of in-hospital cardiac-arrest patients survive to hospital discharge.

A major obstacle to better care for in-hospital cardiac arrest is the inability to gather reliable data, said lead author Laurie Morrison, MD, MSc. “We must be able to count how many in-hospital cardiac arrests occur and report comparable outcomes across institutions — and apply the science to everyday care more quickly,” she said.

The statement’s key recommendations include:

  • Establishing the competency of all hospital staff in recognizing a cardiac arrest, in performing chest compressions, and in using an automated external defibrillator (AED).
  • Ensuring that best practices are used in all stages of care for cardiac arrest.
  • Requiring that all in-hospital cardiac arrests be reported, with survival data, using consistent definitions across hospitals. Current definitions are not standardized, the authors said.
  • Mandating that hospitals report rates per 1,000 admissions of do-not-attempt-to-resuscitate orders among patients before an arrest occurs. Variations in reporting and implementing these orders can dramatically skew data about patient outcomes.
  • Modifying billing codes to allow the collection of more specific and accurate data for in-hospital cardiac arrest.

The authors also suggest separate guidelines for in-hospital versus out-of-hospital cardiac arrests.

Source: American Heart Association; March 11, 2013.

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