Personal Injury Law

Code Blue Survival in Hospitals Best On Weekdays

By Jane Akre

If you can choose when to have your heart attack, choose the weekday. 

Those who had cardiac arrest in the hospital at night or over the weekend had the poorest outcomes according to U.S. researchers.

That may be partially due to fewer staff during off-peak hours. Other studies have shown that doctors make more mistakes at night. 

Having a heart attack in the hospital during the day yielded a nearly 20 percent survival rate. At night after 11 p.m. that dropped to 14.7 percent.

A heart attack or cardiac arrest is called a "Code Blue" and sees a rush of personnel delivering a crash cart bedside to perform CPR, administer drugs or the paddles, that is a defibrillator, to restart the heart. 

If you can choose your location to have the cardiac arrest, the emergency room seems to have the adequate staffing and more senior level physicians whether night or day.

During cardiac arrest minutes count. When the heart stops circulating blood, CPR or cardiopulmonary resuscitation must be performed or patients can die within minutes.

These results are reported in the Journal of the American Medical Association (JAMA) and used data from the national Registry of Cardiopulmonary Resuscitation.

They looked at the survival rates of cardiac arrest among 86,000 adults who had heart attacks between January 2000 and February 2007 in more than 500 U.S. hospitals.

The American Heart Association recently reported that stroke patients had poorer outcomes on nights and weekends as well.

Patients who have a heart attack in the hospital are usually among the very sick and do not have a great survival rate regardless of the time of day. And there may be something about the night hours that makes the stopped heart difficult to restart.

As far as practical conclusions -- hospitals need to improve their staff and resuscitation systems during the wee hours of the morning and on weekends.

"It's a strong message to hospitals and the people who run them that they should critically evaluate how they perform resuscitation," said Dr. Mary Ann Peberdy, who conducted the study. #

Full post as published by InjuryBoard on February 20, 2008 (boomark / email).