Wednesday, February 20, 2008
There was no difference in the emergency room between day and night survival.
CHICAGO (AP) — Many hospitals call it “code blue,” a signal given over the intercom when a patient’s heart has stopped. When code blue works well, a team speeds to the bedside and revives the patient.
The graveyard shift is the worst time to call code blue, a new study finds. Patients who go into cardiac arrest while in the hospital are more likely to die if it happens after 11 p.m., when staffing may be lower or patients watched less closely.
“Our findings should be a pretty big wake-up call to urge hospitals to critically evaluate how they are performing resuscitation,” said the study’s lead author, Dr. Mary Ann Peberdy of the Virginia Commonwealth University Health System in Richmond. “It may well be possible that there is a less effective and less efficient response at night.”
The study, appearing in today’s Journal of the American Medical Association, didn’t examine why days and overnights differed. But researchers found among the late-night cases a higher portion of instances where patients were discovered with no heart electrical activity, that is, too late to deliver a lifesaving shock.
Staff who are fatigued, less experienced or too few in number could be to blame, researchers speculated. Weekends had lower survival rates than weekdays, but the difference wasn’t as pronounced as between late night and daytime hours.
Only in the emergency room was there no night-or-day difference in survival.
The study was based on an analysis of more than 86,000 cardiac arrests in more than 500 hospitals over seven years.