Acute and Critical Care

Original Articles

Rapid response system
Rapid Response Systems Reduce In-Hospital Cardiopulmonary Arrest: A Pilot Study and Motivation for a Nationwide Survey: Yeonhee Park, Jong-Joon Ahn, Byung Ju Kang, Young Seok Lee, Sang-Ook Ha, Jin-Soo Min, Woo-Hyun Cho, Se-Hee Na, Dong-Hyun Lee, Seung-Yong Park, Goo-Hyeon Hong, Hyun-Jung Kim, Sangwoo Shim, Jung-Hyun Kim, Seok-Jeong Lee, So-Young Park, Jae Young Moon; Korean J Crit Care Med. 2017;32(3):231-239. Published online August 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00024

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Background
Early recognition of the signs and symptoms of clinical deterioration could diminish the incidence of cardiopulmonary arrest. The present study investigates outcomes with respect to cardiopulmonary arrest rates in institutions with and without rapid response systems (RRSs) and the current level of cardiopulmonary arrest rate in tertiary hospitals. Methods: This was a retrospective study based on data from 14 tertiary hospitals. Cardiopulmonary resuscitation (CPR) rate reports were obtained from each hospital to include the number of cardiopulmonary arrest events in adult patients in the general ward, the annual adult admission statistics, and the structure of the RRS if present. Results: Hospitals with RRSs showed a statistically significant reduction of the CPR rate between 2013 and 2015 (odds ratio [OR], 0.731; 95% confidence interval [CI], 0.577 to 0.927; P = 0.009). Nevertheless, CPR rates of 2013 and 2015 did not change in hospitals without RRS (OR, 0.988; 95% CI, 0.868 to 1.124; P = 0.854). National university-affiliated hospitals showed less cardiopulmonary arrest rate than private university-affiliated in 2015 (1.92 vs. 2.40; OR, 0.800; 95% CI, 0.702 to 0.912; P = 0.001). High-volume hospitals showed lower cardiopulmonary arrest rates compared with medium-volume hospitals in 2013 (1.76 vs. 2.63; OR, 0.667; 95% CI, 0.577 to 0.772; P < 0.001) and in 2015 (1.55 vs. 3.20; OR, 0.485; 95% CI, 0.428 to 0.550; P < 0.001). Conclusions: RRSs may be a feasible option to reduce the CPR rate. The discrepancy in cardiopulmonary arrest rates suggests further research should include a nationwide survey to tease out factors involved in in-hospital cardiopulmonary arrest and differences in outcomes based on hospital characteristics.

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Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
Critical Care Medicine.2024; 52(2): 314. CrossRef
2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support
Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Woo Jin Jung, Dong Keon Lee, Young Il Roh, Tae Youn Kim, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu C
Clinical and Experimental Emergency Medicine.2021; 8(S): S26. CrossRef
Intensivists' Direct Management without Residents May Improve the Survival Rate Compared to High-Intensity Intensivist Staffing in Academic Intensive Care Units: Retrospective and Crossover Study Design
Jin Hyoung Kim, Jihye Kim, SooHyun Bae, Taehoon Lee, Jong-Joon Ahn, Byung Ju Kang
Journal of Korean Medical Science.2020;[Epub] CrossRef
Influence of the Rapid Response Team Activation via Screening by Nurses on Unplanned Intensive Care Unit Admissions
Ye-Ji Huh, Seongmi Moon, Eun Kyeung Song, Minyoung Kim
Korean Journal of Adult Nursing.2020; 32(5): 539. CrossRef
Rapid response systems in Korea
Bo Young Lee, Sang-Bum Hong
Acute and Critical Care.2019; 34(2): 108. CrossRef

A Simulation Study for Quality of Chest Compression Provided by Health Personnel: Jun Mo Yeo, Min Hong Choa, Sang Won Chung, In Byung Kim, Ji Hoon Kang, Kyung Wuk Kim, Jai Woog Ko; Korean J Crit Care Med. 2011;26(2):64-68.; DOI: https://doi.org/10.4266/kjccm.2011.26.2.64

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Abstract PDF

BACKGROUND
Effective chest compression may improve the return of spontaneous circulation and neurologic outcome in arrest victims. For fear of rescuer's fatigue, guidelines for cardiopulmonary resuscitation (CPR) recommended that chest compression (CC) should be switched every 2 minutes, but there is little evidence. We investigated whether health personnel could provide consistent quality of CC for 2 minutes.
METHODS
We recruited prospectively health personnel working on one university hospital. On the day assigned randomly, CPR performance data was collected with use of CPR recording technology. Quality of CPR was calculated every 30 seconds interval. To identify the quality decay, we used repeated measure analysis of variance with SPSS 17.0 for analysis.
RESULTS
We analyzed 8,485 CCs performed by 41 subjects. Total number of CC decayed between 90 to 120 seconds (51.6 +/- 3.3 to 50.8 +/- 3.5, p = 0.020) within recommended range. The ratio of correct depth CC decayed between 90 to 120 seconds, falling from 83.4 +/- 24.9% to 68.3 +/- 38.4% (p = 0.002). The ratio of low depth CC increased significantly over time (10.2 +/- 20.7% to 31.3 +/- 38.5%, p < 0.001).
CONCLUSIONS
Health personnel may provide adequate number of CC for 2 minutes. But, the number of correct depth CC may decay between 90 to 120 seconds. Also the number of low depth CC may increase over time.

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Citations to this article as recorded by

Comparisons of the qualities of chest compression according to various positions of rescuer to patient at the in-hospital cardiopulmonary resuscitation model
Geon-Nam Kim, Seong-Woo Choi, Jin-Yeong Jang, So-Yeon Ryu
The Korean Journal of Emergency Medical Services.2014; 18(1): 7. CrossRef
Comparison on the Quality and fatigue of hands-Only CPR According to the Presence or Absence of Verbal counting by Some Middle-aged Women
Geon-Nam Kim, Sung-Soo Choi, Seong-Woo Choi
Journal of the Korea Academia-Industrial cooperation Society.2013; 14(3): 1320. CrossRef

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