Outcomes of Resuscitation in Tertiary Emergency Department by In-Hospital Utstein Style

Song,  Keun Jeong; Lee,  Jeong Hun; Sung,  Il Soon; Jeong,  Yeon Kwon; Choi,  Sung Wook

J Korean Soc Emerg Med > Volume 12(1); 2001 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2001;12(1): 27-35.

Outcomes of Resuscitation in Tertiary Emergency Department by In-Hospital Utstein Style

Keun Jeong Song, Jeong Hun Lee, Il Soon Sung, Yeon Kwon Jeong, Sung Wook Choi

¹Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. emsong@smc.samsung.co.kr
²Emergency Nursing Department, Samsung Medical Center, Korea.
³Department of Emergency Medicine, Bundang Cha Hospital, Pochon Cha University College of Medicine, Korea.

ABSTRACT

BACKGROUND: To assess and report the outcomes of resuscitation, we apply the 1997 published In-Hospital Utstein Style to an actual emergency department. This study was designed to develope the data base for comparing and studing the outcomes of resuscitation.
METHODS:
This study was carried out in a tertiary hospital from July 1998 to June 1999. The subjects were adult patients over the age of 20 years who received resuscitation at the emergency department. After making out the protocol for the In-Hospital Utstein Style, we gathered data prospectively.
RESULTS:
Among 51,347 patients, 36 patients received 42 resuscitations. Forty-two(42) cases(100%) had witnessed arrest. Advance life support(ALS) intervention at the time of cardiac arrest included intravenous catheterization, 41cases(97.6 %); intravenous drug injection, 20 cases(47.6%); endotracheal intubation, 20 cases(47.6%); and artificial ventilation, 12 cases(28.6%). Immediate causes of cardiac arrest were respiratory depression, 11 cases(26.2%); hypotension, 11 cases(26.2 %); metabolic, 9 cases(21.4%); and myocardial ischemia/infarction, 5 cases(11.9%). Initial EKG ryhthms were pulseless electrical activity, 31 cases(73.8 %); ventricular tachycardia/fibrillation, 6 cases(14.3%); and asystole, 5 cases(11.9%). the average interval from cardiac arrest to initial defibrillation was 1.8+/-2.2 minutes, and the average interval from cardiac arrest to epinephrine injection was 2.6+/-3.1 minutes. The average duration of resuscitation was 22.6+/-18.4 minutes. Return of spontaneous circulation occured in 26 cases/42 case(61.9%). Of the 2 survivng patients who were discharged, 1 patient is still alive after 6 months, and the other is still alive after 1 year.
CONCLUSION:
Although the In-Hospital Utstein Style has many complementary factors, its results were very objective thus use of the In-Hospital Utstein Style is recommended for determining the outcomes of resuscitation.

Key words: Resuscitation outcome, In-Hospital Utstein Style