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Cardiac arrest teams and medical emergency teams in F inland: a nationwide cross‐sectional postal survey
Author(s) -
TIRKKONEN J.,
NURMI J.,
OLKKOLA K. T.,
TENHUNEN J.,
HOPPU S.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12280
Subject(s) - medicine , cross sectional study , emergency medicine , emergency medical services , resuscitation , medical emergency , cardiopulmonary resuscitation , debriefing , pathology , medical education
Background The implementation, characteristics and utilisation of cardiac arrest teams ( CATs ) and medical emergency teams ( METs ) in F inland are unknown. We aimed to evaluate how guidelines on advanced in‐hospital resuscitation have been translated to practice. Methods A cross‐sectional postal survey including all public hospitals providing anaesthetic services. Results Of the 55 hospitals, 51 (93%) participated in the study. All hospitals with intensive care units (university and central hospitals, n = 24) took part. In total, 88% of these hospitals (21/24) and 30% (8/27) of the small hospitals had CATs . Most hospitals with CATs (24/29) recorded team activations. A structured debriefing after a resuscitation attempt was organised in only one hospital. The median incidence of in‐hospital cardiac arrest in F inland was 1.48 ( Q 1 = 0.93, Q 3 = 1.93) per 1000 hospital admissions. METs had been implemented in 31% (16/51) of the hospitals. A physician participated in MET activation automatically in half (8/16) of the teams. Operating theatres (13/16), emergency departments (10/16) and paediatric wards (7/16) were the most common sites excluded from the METs ' operational areas. The activation thresholds for vital signs varied between hospitals. The lower upper activation threshold for respiratory rate was associated with a higher MET activation rate. The national median MET activation rate was 2.3 (1.5, 4.8) per 1000 hospital admissions and 1.5 (0.96, 4.0) per every cardiac arrest. Conclusions Current guidelines emphasise the preventative actions on in‐hospital cardiac arrest. Practices are changing accordingly but are still suboptimal especially in central and district hospitals. Unified guidelines on rapid response systems are required.