Abstract
Background
Out-of hospital cardiac arrest (OHCA) is associated with significant mortality. Therapeutic
hypothermia is one of the few interventions that have been shown to increase post-arrest
survival as well as enhance neurologic recovery. Despite clinical guidelines recommending
the use of therapeutic hypothermia (TH) following cardiac arrest, utilization rates
by physicians remain low. We hypothesized that the development of a multi-disciplinary
emergency cardiac arrest response team (eCART) would enhance therapeutic hypothermia
utilization in the emergency department for OHCA.
Methods and results
An eCART (emergency department cardiac arrest response team) was created at a single
site academic urban emergency department. The eCART team consisted of a physician
hypothermia consultant, a cardiologist, a clinical pharmacist, a respiratory therapist
and a chaplain. These providers were notified by page prior to the arrival of an OHCA
patient and responded to the ED in person or by phone to support the resuscitation.
Analysis of pre- and post-intervention data demonstrated a significant increase in
the rate of TH utilization (64% to 96%). There was a non-significant decrease in the
time to target temperature.
Conclusions
The creation of a coordinated, multi-disciplinary care team, providing real-time support
for OHCA patients increased TH utilization in an emergency department.
Keywords
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Article info
Publication history
Published online: October 16, 2014
Accepted:
October 6,
2014
Received in revised form:
September 21,
2014
Received:
June 27,
2014
Footnotes
☆A Spanish translated version of the summary of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2014.10.006.
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
