Evaluation of a medical emergency team dedicated to vital distress treatment

Objective: To assess the activities of a medical emergency team on intra-hospital cardiac arrest and vital distress (intra-hospital chain of survival-CSIH). Methodology: It is a retrospective study over a period of six months (from November 2010 to April 2011) in a hospital with 720 beds and 89,000 annual admissions. Epidemiological and clinical data were analyzed by a systematic survey of all procedures performed following calls on a dedicated line. Call criteria were defined by the occurrence of cardiac arrest or vital distress. Results: 99 patients were enrolled, with a mean age of 66 +/- 17 years; 22% had a cardiac arrest, and 77% had vital distress. The main reasons of calls were respiratory distress in 30% and cardiopulmonary arrest in 25% of cases. A therapeutic limitation has been decided for 71% of patients. In case of cardiac arrest, basic resuscitation was started by the witness in 73%, while specialized resuscitation has been started 4.5 min [3-6.5] after the first call. Mortality at 48 hours was 100% for cardiac arrest and 29% for vital distress. Conclusion: The occurrence of intra-hospital cardiac arrest in our study was associated with 100% mortality. The significantly lower mortality following intra-hospital vital distress supports the development of a dedicated team for both cardiac arrest and vital distress, with a logic of prevention.