The sounds of cardiac arrest: Innovating to obtain an accurate record during in-hospital cardiac arrest

Background: To obtain an accurate audit during in-hospital cardiac arrest, following recommendations of the Utstein style and measuring time intervals between the different interventions, is difficult. Objective: To assess whether the use of an audio recording system during in-hospital cardiac arrest resuscitation allows the register of more items during cardiopulmonary resuscitation. Material and methods: Prospective observational study between January 2008 and December 2009. The population that were included, were hospitalized patients and non-hospitalized patients assisted by a cardiac arrest team, except for critical areas. An audio recording system with a timer was turned on when cardiac arrest team was alerted. Recordings were reviewed to fill in the items recommended by the Utstein style. Time intervals were calculated. Mean number of completed items per patient were compared between recorded and non-recorded cardiac arrest. Results: 119 CA team alerts took place. 64 (53.7%) cases were real CA and 37 (57.8%) of them were properly recorded. A mean number of items per patient in recorded cardiac arrest cases were 18.18 (±3.2) vs. 15.96 (±4.1) in non-recorded cardiac arrest cases (p< 0.05). In the recorded cases, mean times were: alert - arrival: 1.23 (±0.95). min; arrival - cardiopulmonary resuscitation initiation: 0.63 (±0.38). min; arrival - first defibrillation: 2.06 (±1.33). min; arrival - intubation: 8.42 (±4.64). min; arrival - first adrenaline: 3.30 (±1.98). min. Conclusions: The audio recording system permits the register of a larger number of items per patient during in-hospital cardiac arrest and allows measurement of time intervals between the different interventions during cardiopulmonary resuscitation. © 2012 Elsevier Ireland Ltd.