Impact of a COVID-19 code blue protocol on resuscitation care and CPR quality during in-hospital cardiac arrest

被引：1

作者：

Vaillancourt, Christian ^{[1
,2
,3
]}

Charette, Manya ^{[3
]}

Khorsand, Soha ^{[3
]}

Shligold, Erica ^{[3
]}

Lanos, Chelsea ^{[3
]}

Dale-Tam, Jennifer ^{[4
]}

Tran, Alexandre ^{[3
,5
,6
]}

Boyle, Loree ^{[7
]}

Aucoin, Sylvie ^{[8
]}

Maniate, Jerry ^{[6
,9
]}

Meggison, Hilary ^{[6
]}

Hartwick, Michael ^{[6
]}

Posner, Glenn ^{[3
,10
]}

机构：

[1] Ottawa Hosp, Clin Epidemiol Unit, Civic Campus,F649 1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada

[2] Univ Ottawa, Dept Emergency Med, Ottawa, ON, Canada

[3] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[4] Ottawa Hosp, Ottawa, ON, Canada

[5] Univ Ottawa, Dept Surg, Ottawa, ON, Canada

[6] Univ Ottawa, Div Crit Care Med, Ottawa, ON, Canada

[7] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[8] Univ Ottawa, Dept Anesthesiol & Pain Med, Ottawa, ON, Canada

[9] Bruyere Res Inst, Ottawa, ON, Canada

[10] Univ Ottawa, Dept Obstet & Gynecol, Ottawa, ON, Canada

来源：

RESUSCITATION | 2024年 / 198卷

关键词：

COVID-19; pandemic; In-hospital cardiac arrest; Personal protective equipment; Cardiopulmonary resuscitation quality metrics; INTERNATIONAL LIAISON COMMITTEE; CARDIOPULMONARY-RESUSCITATION; DNACPR DECISIONS; TASK-FORCE; RECOMMENDATIONS; STATEMENT; CONSENSUS; SCIENCE;

D O I：

10.1016/j.resuscitation.2024.110172

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective : We sought to evaluate the impact of a COVID-19 Code Blue policy on in -hospital cardiac arrest (IHCA) processes of care, cardiopulmonary resuscitation (CPR) quality metrics, and survival to hospital discharge. Methods : We completed a health record review of consecutive IHCA for which resuscitation was attempted. We report Utstein outcomes and CPR quality metrics 33 months before (July,2017-March,2020) and after (April,2020-December,2022) the implementation of a COVID-19 Code Blue policy requiring all team members to don personal protective equipment including gown, gloves, mask, and eye protection for all IHCA. Results : There were 800 IHCA with the following characteristics (Before n = 396; After n = 404): mean age 66, 62.9% male, 81.3% witnessed, 31.3% in the emergency department, 25.6% cardiac cause, and initial shockable rhythm in 16.7%. Among all 404 patients screened for COVID19, 25 of 288 available test results before IHCA occurred were positive. Comparing the before and after periods: there were relevant time delays (min:sec) in start of chest compressions (0:17vs.0:37;p = 0.005), team arrival (0:43vs.1:21;p = 0.002), 1st rhythm analysis (1:15vs.3:16; p < 0.0001), 1st epinephrine (3:44vs.4:34;p = 0.02), and airway insertion (8:38vs. 10:18;p = 0.02). Resuscitation duration was similar (18:28vs.19:35;p = 0.34). Exception of peri-shock pause which appeared longer (0:06vs.0:14;p = 0.07), chest compression fraction, rate and depth were identical and good. Factors independently associated with survival were age (adjOR 0.98;p < 0.001), male sex (adjOR 1.51;p = 0.048), witnessed (adjOR 2.35;p = 0.02), shockable rhythm (adjOR 3.31;p < 0.0001), hospital location (p = 0.0002), and COVID-19 period (adjOR 0.68; p = 0.052). Conclusions : The COVID-19 Code Blue policy was associated with delayed processes of care but similarly good CPR quality. The COVID-19 period appeared associated with decreased survival.

引用

页数：9

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