In-Hospital Cardiac Arrest

Abstract

A cardiac arrest is classified as ‘in-hospital’ (IHCA) if it occurs in a hospitalized patient who had a pulse at the time of admission. Unfortunately, the majority of patients resuscitated successfully from IHCA die before hospital discharge, and their prognosis has changed little over the past 30 years. Recent data indicate that survival to hospital discharge after in-hospital cardiac arrest is approximately 20%. A variety of factors have been proposed as determinants of poor outcomes associated with IHCA, which include first monitored rhythm, time to first shock, duration of cardiac arrest, hospital location of cardiac arrest and time of day of cardiac arrest occurrence. According to current guidelines for prevention of in-hospital cardiac arrest, hospitals should provide a system of care that includes staff education for rapid response, appropriate and regular patient vital sign monitoring, clear and uniform system of timely calling for assistance. Finally, after cardiac arrest has occurred, the quality of resuscitation and early defibrillation are crucial factors for improving survival.