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Almost one-third of hospitalized patients who go into cardiac arrest don't receive defibrillation within the recommended 2 minutes, new study results show. Researchers tracked response times and outcomes using data from a national registry of 369 hospitals. The registry included 6,789 cases of cardiac arrest from ventricular fibrillation or pulseless ventricular tachycardia. The overall median time to defibrillation was 1 minute, but 2,045 patients (30%) experienced delayed defibrillation (2 minutes or more). Characteristics associated with delayed defibrillation included black race, a noncardiac admitting diagnosis, smaller hospitals (fewer than 250 beds), unmonitored hospital units, weekends, and the period from 5 p.m. to 8 a.m.
Delayed defibrillation was linked to a significantly lower probability of surviving to hospital discharge: 22% for delayed defibrillation versus 39% for defibrillation within 2 minutes. Every minute of delay was associated with worsening survival chances.
To speed up response times, lead researcher Paul S. Chan, MD, recommends providing more automated external defibrillators throughout hospitals so nurses and other staff trained in basic life support can readily use them. Using wireless technology to monitor patients would also help.
Chan PS, et al., Delayed time to defibrillation after in-hospital cardiac arrest, The New England Journal of Medicine, January 3, 2008.
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