More than 200,000 Patients are treated when their heart stops in the hospital every year, and A. study Published Wednesday reveals whether they develop brain damage or die as a result, depending on Hospital They are staying inside.
The findings, published Wednesday in JAMA Cardiology, show that hospitals differ substantially in how they care for patients with cardiac arrest. If the protocol was followed in all hospitals that followed it most closely, the study authors estimate that more than 24,200 lives would be saved each year.
Dr. Monique Anderson, lead study writer and assistant professor of medicine in the division of cardiology Duke University, States that such studies can help inform what kind of quality measures are undertaken in hospitals, to find out how they should be reimbursed for care, and whether they should There is a need to report data publicly.
“Many hospitals will say,” We don’t need a second remedy. But our study shows that there is significant variability, ”says Anderson.
Often, patients who have cardiac arrest are in hospital for reasons other than heart problems. According to the National Heart, Lung and Blood Institute of the National Institutes of Health, early treatment for cardiac arrest is important because it can prevent or limit damage to the heart muscle. After cardiac arrest, a patient may have difficulty thinking, becoming disabled, in a coma, or becoming brain dead – And the worst outcomes are more likely when protocols for heart attacks are not followed correctly or on time.
To conduct the study, the researchers used data from over 35,000 patients who were treated in 241 hospitals in the US from January 1, 2010 to December 31, 2012. They investigated whether the patient Survived cardiac arrest, And if so, whether there was any brain damage when they were discharged.
They also see if Hospital Followed the guidelines created by the American College of Cardiology and the American Heart Association for the care of patients with cardiac arrest. This includes a nurse or a telemetry monitor witnessing cardiac arrest. Anderson explains that this factor also helps to demonstrate that a hospital has a better nurse-to-patient ratio for witnessing cardiac arrest. The monitor is used for some patients, including those in intensive care, as a way to keep track of heart rate and rhythm.
After a cardiac arrest is detected, the guidelines specify that hospital staff insert a tube into a patient’s mount to provide oxygen, do chest contractions no longer than one minute, and no more than two minutes after insertion Oxygen tubes also use a defibrillator to shock the heart for a short time. If a pulse is not detected after five minutes, the guidelines specify that the drugs epinephrine or vasopressin should be administered to help with blood pressure.
According to the authors of the study, hospitals have different levels of ability to follow protocols when a patient has a heart attack, and those who follow the steps are more likely to follow them. it occurs.
Specifically, patients who were shocked by a defibrillator within two minutes were 50 percent more likely to survive than those who had a delay.
“A lot of hospitals are doing fine, but a lot of hospitals can do better, and others can actually do better, ”says Anderson.