In-hospital cardiac arrest: characteristics and outcome after implementation of systematic practice-oriented training

Published:April 14, 2014DOI:


      Survival after in-hospital cardiac arrest (CA) has been reported to be surprisingly low without any major improvement during the last decade. Cardiopulmonary resuscitation (CPR) quality affects survival after CA, and specific education is necessary for health care professionals participating in CPR. Decisions regarding CPR and do not attempt resuscitation (DNAR) orders remain demanding, as does including patients in the process. Addressed training regarding CPR/DNAR orders is necessary to improve the CPR/DNAR decision process used by physicians. The aim of this retrospective study is to evaluate the clinical impact (return of spontaneous circulation and 21-day survival after CA) of an intervention within one single hospital, including a systematic education of all health care professionals in CPR. In total, there were 33 in-hospital CAs before (12 months) and 176 after (36 months) the intervention. No significant difference was found between the 2 calendar periods.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Deakin C.D.
        • Nolan J.P.
        • Soar J.
        • et al.
        European Resuscitation Council Guidelines for Resuscitation 2010. Section 4. Adult advanced lifesupport.
        Resuscitation. 2010; 81: 1305-1352
        • Sandroni C.
        • Nolan J.
        • Cavellaro F.
        • et al.
        In hospital cardiac arrest: incidence, prognosis and possible measures to improve survival.
        Intensive Care Med. 2007; 33: 237-245
        • Peberdy M.A.
        • Kaye W.
        • Ornato J.P.
        • et al.
        Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the national Registry of Cardiopulmonary Resuscitation.
        Resuscitation. 2003; 58: 297-308
        • Herlitz J.
        red.nationellt register för hjärtestopp.
        Årsrapport 2010. HLR Rådet, Svenska rådet för hjärt-lungräddning, Göteborg2010
        • Krarup N.H.V.
        • Løfgren B.
        • Hansen T.K.
        • et al.
        Registrering af hjertestop på hospital er en udfordring i den kliniske hverdag.
        Ugeskr Laeger. 2012; 174: 856-859
        • Jacobs I.
        • Nadkarni V.
        • Bahr J.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries.
        Resuscitation. 2004; 63: 233-249
        • Gehan E.A.
        Clinical trials in cancer research.
        Environ Health Perspect. 1979; 32: 31-48
        • Källestedt M.L.S.
        • Berglund A.
        • Enlund M.
        • et al.
        In hospital cardiac arrest characteristics and outcome after defibrillator implementation and education: from 1 single hospital in Sweden.
        Am J Emerg Med. 2012; 30: 1712-1718
        • Lippert F.K.
        Education as standardized teaching or individual training or both.
        Resuscitation. 2013; 84: 1171-1172
        • Nielsen N.
        • Wetterslev J.
        • Cronberg
        • TTM investigators
        • et al.
        Targeted temperature management at 33°C versus 36°C after cardiac arrest.
        N Engl J Med. 2013; 369: 2197-2206
        • Edelson D.P.
        • Litzinger B.
        • Aora V.
        • et al.
        Improving in-hospital cardiac arrest process and outcomes with performance debriefing.
        Arch Intern Med. 2008; 168: 1063-1069
        • Skrifvars M.B.
        • Castren M.
        • Nurmi J.
        • et al.
        Do patient characteristics or factors at resuscitation influence long term outcome in patients surviving to be discharged following in-hospital cardiac arrest.
        J Intern Med. 2007; 262: 488-495
        • Lake Research Partners and the Coalition for Compassionate Care of California
        Californians’ attitudes and experiences with death and dying.
        ([Accessed 5th of December 2013])
        • Tulsky J.A.
        • Fischer G.S.
        • Rose M.R.
        • et al.
        Opening the black box: how do physicians communicate about advance directives?.
        Ann Intern Med. 1998; 129: 441.9
        • Lippert F.K.
        • Raffay V.
        • Georgiou M.
        • et al.
        European Resuscitation Council Guidelines for Resuscitation 2010 Section 10. The ethics of resuscitation and end-of-life decisions.
        Resuscitation. 2010; 81: 1445-1451