Survival increases with clinical team debriefing after in-hospital cardiac arrest

Lessons learned prepare team for future cases and increase chance of favorable neurologic outcome

2014-08-04

(Press-News.org) A new study found that staff members who joined structured team debriefings after emergency care for children suffering in-hospital cardiac arrests improved their CPR performance and substantially increased the rates of patients surviving with favorable neurological outcomes.

The study team, at The Children's Hospital of Philadelphia (CHOP), said their research suggests that including all members of the intensive care unit (ICU) team, not just those immediately involved in the cardiac arrests, broadens learning and may improve compliance with standardized national guidelines for performing CPR. "Bringing together all members of the multidisciplinary team for a post-event debrief better prepares everyone who could come in future contact with a patient in sudden cardiac arrest," said lead author Heather Wolfe, M.D., a critical care physician at The Children's Hospital of Philadelphia.

More than 200,000 cardiac arrests occur every year in U.S. hospitals. And while survival outcomes have improved over the last ten years, still more than 60 percent of these patients will not make it out of the hospital alive. This fact highlights how important it will be to disseminate the team's successful findings.

The current study appears in a recent issue of Critical Care Medicine.

The researchers performed a single-center prospective study of children who received chest compressions in the ICU at CHOP between December 2008 and June 2012, encompassing 120 CPR events. The study team compared a historical control group, up to June 2010, with an intervention group of patients receiving CPR between December 2010 and June 2012, following the implementation of the post-arrest debriefing program. Patient survival with favorable neurologic outcome increased to 50 percent among the intervention group, compared to 29 percent during the pre-intervention period.

"The team debriefings were associated with a near-doubling of good neurological survival for children who suffer a cardiac arrest in our ICU," said Wolfe, who added, "Our unique, interdisciplinary debriefing program resulted in improvements of CPR technique to levels of American Heart Association (AHA) Guideline compliance previously not thought possible –this was truly a stellar achievement."

At The Children's Hospital of Philadelphia, all ICU physicians, respiratory therapists and nurses are certified in pediatric advanced life support and/or advanced cardiovascular life support and participate in frequent mock code and rolling refresher CPR training.

"This study demonstrates how doctors, nurses, and other healthcare providers can come together to improve in-hospital care and save lives," said Robert Sutton, M.D., M.S.C.E., chair of the hospital's Resuscitation Committee and senior author on the project.

"This is the first study in children showing that pre-training with simulation and debriefing teams on how we can do it better improves survival. It also highlights what a unique program we have here for cardiac arrest patients from prevention, care during arrest, and post-arrest care," said Robert Berg, M.D., chief of critical care medicine at The Children's Hospital of Philadelphia.

INFORMATION: "Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes," Critical Care Medicine, July 2014 issue.

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program receives the highest amount of National Institutes of Health funding among all U.S. children's hospitals. In addition, its unique family-centered care and public service programs have brought the 535-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

ELSE PRESS RELEASES FROM THIS DATE:

Study examines viewers' role in American death penalty films

2014-08-04

Over the course of the last 100 years or more, many scenes of execution in American film have offered intimate knowledge of executions, giving viewers a privileged 'backstage' gaze of an execution not available outside film, the chance to see what executioners see, and a chance to understand the condemned's experience as he awaits death. These motifs are explored in a recent Law & Social Inquiry analysis, in which the authors conclude by asking whether and how scenes of execution in American film provoke an awareness of the political responsibility inherent in viewers' ...

Researchers identify potential gene that may increase risk of ad in African Americans

2014-08-04

(Boston)-- Researchers from Boston University School of Medicine (BUSM) report that two rare variants in the AKAP9 gene significantly increase the risk of Alzheimer's disease (AD) in African-Americans. This previously unknown association furthers the understanding of the role of genetic factors in the development of AD, according to the researchers, whose findings appear in Alzheimer's & Dementia. AD is the most frequent age-related dementia affecting 5.4 million Americans including 13 percent of people age 65 and older and more than 40 percent of people age 85 and ...

Patients with hypoventilation may need supplemental oxygen on-board flights

2014-08-04

Severely overweight people who suffer from hypoventilation can have abnormally low levels of oxygen (hypoxaemia) in their blood during air travel as a result of reduced atmospheric pressure in the cabin of aircrafts. In a recent Respirology study, even patients diagnosed with obesity hypoventilation syndrome who were in the care of specialist and had normal daytime blood oxygen levels were still at risk of hypoxaemia when flying. "The findings suggest that it is advisable for all hypoventilation syndrome patients to do a hypoxic challenge test before air travel to be ...

Baby universe picture brought closer to theory

2014-08-04

Last year, the Planck Telescope revealed the most detailed picture of the cosmic microwave background, the relic radiation from the Big Bang. But this map contains features that challenge the standard model of cosmology, the theory that describes our entire Universe from early on. Who is right, the map or the theory? Scientists from EPFL (Switzerland) and CEA (France) have shown that several of these enigmatic features disappear from the map by processing Planck telescope's data differently and including other effects, such as the motion of the Milky Way. The findings are ...

New material allows for ultra-thin solar cells

2014-08-04

This news release is available in German. Extremely thin, semi-transparent, flexible solar cells could soon become reality. At the Vienna University of Technology, Thomas Mueller, Marco Furchi and Andreas Pospischil have managed to create a semiconductor structure consisting of two ultra-thin layers, which appears to be excellently suited for photovoltaic energy conversion Several months ago, the team had already produced an ultra-thin layer of the photoactive crystal tungsten diselenide. Now, this semiconductor has successfully been combined with another layer ...

New recommendations for post-treatment care of prostate cancer survivors

2014-08-04

New Rochelle, NY, August 4, 2014 -- Many of the more than 2.5 million men in the U.S. who have received treatment for prostate cancer deal with the often disabling side effects of surgery and radiation and hormonal therapies. To aid in the transition of these patients from specialty to primary care for long-term management of problems such as urinary incontinence and sexual and bowel dysfunction, updated guidelines for prostate cancer survivorship care are published in Journal of Men's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article ...

Patient navigation may aid in breast cancer treatment in high-risk populations

2014-08-04

(Boston) -- Patient navigation, or the linking of a newly diagnosed cancer patient with a professional trained in assisting patients though the complex journey of cancer diagnosis and treatment, may lead to better breast cancer care in high risk and minority women. The findings, recently published in the Journal of Clinical Oncology, is the first national study to show a relationship between navigators and the initiation of certain recommended treatments in breast cancer. Using data from a previously published, multi-center study funded by the National Cancer Institute, ...

Tricking plants to see the light may control the most important twitch on Earth

2014-08-04

MADISON, Wis. — Copious corn growing in tiny backyard plots? Roses blooming in December? Thanks to technology that the University of Wisconsin-Madison's Richard Vierstra has been developing for years, these things may soon be possible. And now, new findings out of the genetics professor's lab promise to advance that technology even further. For the first time, Vierstra and his team have revealed the structure of the plant phytochrome, a critical molecule that detects the light that tells plants when to germinate, grow, make food, flower and even age. Like eyes, the phytochrome ...

Daylight is the best medicine, for nurses

2014-08-04

For the health and happiness of nurses – and for the best care of hospital patients – new Cornell research suggests exposure to natural light may be the best medicine. In a forthcoming Cornell study published in the journal Health Environments Research and Design, Rana Zadeh, assistant professor of design and environmental analysis, discovered nurses who had access to natural light enjoyed significantly lower blood pressure, communicated more often with their colleagues, laughed more and served their patients in better moods than nurses who settled for large doses of ...

Diet change -- A solution to reduce water use?

2014-08-04

Eating less meat would protect water resources in dry areas around the world, researchers at Aalto University in Finland have found. Reducing the use of animal products can have a considerable impact on areas suffering scarce water resources, as meat production requires more water than other agricultural products. Diet change together with other actions, such as reduction of food losses and waste, may tackle the future challenges of food security, states researcher Mika Jalava from Aalto University in Finland. Growing population and climate change are likely to ...