Abstract
Introduction
Studies support rapid interventions to improve outcomes in patients with in-hospital
cardiac arrest. We sought to decrease the time to code team activation and improve
dissemination of patient-specific data to facilitate targeted treatments.
Methods
We mapped code blue buttons behind each bed to patients through the electronic medical
record. Pushing the button sent patient-specific data (admitting diagnosis, presence
of difficult airway, and recent laboratory values) through a secure messaging system
to the responding teams’ smartphones. The code button also activated a hospital-wide
alert through the operator. We piloted the system on seven medicine inpatient units
from November 2019 through May 2022. We compared the time from code blue button press
to smartphone message receipt vs traditional operator-sent overhead page.
Results
The code button was the primary mode of code team activation for 12/35 (34.3%) cardiac
arrest events. The code team received smartphone notifications a median of 78 s (IQR = 47–127 s)
before overhead page. The median time to adrenaline administration for codes activated
with the code button was not significantly different (240 s (IQR 142–300 s for code
button) vs 148 s (IQR = 34–367 s) for overhead page, p = 0.89). Survival to discharge was 3/12 (25.0%) for codes activated with the code
button vs 4/23 (17.4%) when activated by calling the operator (p = 0.67).
Conclusion
Implementation of a smartphone-based code button notification system reduced time
to code team activation by 78 s. Larger cohorts are necessary to assess effects on
patient outcomes.
Keywords
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Article info
Publication history
Published online: February 24, 2023
Accepted:
February 20,
2023
Received in revised form:
January 30,
2023
Received:
December 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
