1 / 11

Medication Ingestion Twenty- Four Hours Prior to a Code Blue In a Non-ICU Setting

Medication Ingestion Twenty- Four Hours Prior to a Code Blue In a Non-ICU Setting. Edgardo Ordonez, MD, MPH, Erin Eckhart, RN, BSN, MSN, Megan Farraj, PharmD, Shawn Fellows, PharmD, Anita Witzke, MSN, RN, Penny Rathmanner, RN, BSN, CAPA, Marc T. Zubrow, MD

natala
Download Presentation

Medication Ingestion Twenty- Four Hours Prior to a Code Blue In a Non-ICU Setting

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Medication Ingestion Twenty- Four Hours Prior to a Code Blue In a Non-ICU Setting Edgardo Ordonez, MD, MPH, Erin Eckhart, RN, BSN, MSN, Megan Farraj, PharmD, Shawn Fellows, PharmD, Anita Witzke, MSN, RN, Penny Rathmanner, RN, BSN, CAPA, Marc T. Zubrow, MD Presented by: Edgardo Ordonez, MD, MPH ECCU 2012 Sept 14, 2012

  2. Introduction • The National Registry of Cardiopulmonary Resuscitation (NRCPR) states that the most common causes for cardiac arrests in adults were: • Cardiac dysrhythmia • Acute respiratory insufficiency • Hypotension

  3. Introduction contd. • Much has been published regarding outcomes of in-hospital cardiac arrest (IHCA), which may depend on a variety of factors: • Patient factors • The environment • The extent of resuscitation efforts

  4. Study Goal • To determine if there is an association between cardiopulmonary arrest (and type of arrest) in a non-ICU setting and medication ingestion in the 24-hour period prior to event

  5. Methods • A retrospective cohort study was conducted from a code blue data base including all patients that had a non-ICU, in hospital cardiopulmonary arrest (IHCA), between 1/2007 & 12/2010 in an academic, teaching hospital system

  6. Methods contd. • Medications administered in the 24 hours prior to IHCA were captured from the electronic administration records and included: • Antiarrhythmics • Antidepressants • Antiepileptics • Antiemetics • Antipsychotics • Anxiolytics • Diuretics • Muscle relaxants • Opiates

  7. Methods contd. • Primary outcomes investigated: • Higher medication or combination of medication utilization for a particular arrest group • Association with BMI • Better/worse code outcomes

  8. Results • A total of 435 IHCA’s were analyzed • The most commonly administered medications among IHCA patients included opioids, central nervous system depressants, beta-blockers, and diuretics • After controlling for confounding variables and combining classes, no statistically significant relationship to IHCA’s was found

  9. Conclusion • In a cohort of patients analyzed for medication ingestion 24 hours prior to IHCA, there were no significant findings among individual or combination of medications • Further studies should evaluate a shorter time frame of medication administration and cumulative dosage

  10. References • Peberdy MA, Kaye W, Ornato JP, et al: Cardiopulmonary resuscitation of adults in the hospital: A report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2003; 58:297–308 • Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990 Dec;98(6):1388-92. • Tortolani AJ, Risucci DA, Rosati RJ, et al. In-hospital cardiopulmonary resuscitation: Patient, arrest and resuscitation factors associated with survival. Resuscitation 1990; 20:115–128 • Nadkarni VM, Larkin GL, Peberdy MA, et al:First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA 2006; 295:50–57 • Peberdy MA, Ornato JP, Larkin GL, et al:Survival from in-hospital cardiac arrest during nights and weekends. JAMA 2008; 299:785–792 • Sandroni C, Nolan J, Cavallaro F, et al: Inhospitalcardiac arrest: Incidence, prognosis and possible measures to improve survival. Intensive Care Med 2007; 33:237–245 • Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ. • Adult Advanced Cardiovascular Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S729-67 • Skrifvars MB, Nurmi J, Ikola K, Saarinen K, Castr´en M. Reduced survival following resuscitation in patients with documented clinically abnormal observations prior to in-hospital cardiac arrest. Resuscitation 2006; 70: 215—222. • Jacobs I, Nadkarni V, Bahr J, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa). Circulation, 2004 Nov 23;110(21):3385-97.

  11. THE END

More Related