Identifying the general ward patient at high risk of cardiac arrest

Abstract

Objective: A study was undertaken to determine the incidence of antecedent factors leading to hospital inpatient cardiorespiratory arrests. Design: Review of medical records over five randomly selected 24-hour periods to identify signs known to be antecedents to cardiorespiratory arrest. Setting: General wards of a 460-bed Australian teaching hospital. Interventions: None. Measurements and main results: Of the 1,027 charts reviewed, nine (0.88%) were identified as having signs thought to proceed to cardiac arrest. Systolic blood pressure was less than 90 mmHg in three cases, pulse rate was <40 or >140 bpm in one patient and respiratory rate was <5 or >36 breaths/min in five patients. Conclusions: Signs which have been reported as antecedent factors leading to cardiorespiratory arrest are of sufficient frequency in the general hospital population to make it feasible to institute a standardised, team-based urgent response.