Acute cardiac care & resuscitation
Impact of a COVID-19 code blue protocol on resuscitation care and cardiopulmonary resuscitation (CPR) quality during in-hospital cardiac arrest
Authors' conclusion
The COVID-19 Code Blue policy was associated with delayed processes of care but similarly good CPR quality. The COVID-19 period appeared associated with decreased survival.
Study context
- Population
- In-hospital cardiac arrests with attempted resuscitation
- Participants
- 800 arrests
- Exposure
- After vs before implementation of a COVID-19 Code Blue policy
- Aftern = 404
- Beforen = 396reference
- Outcome
- Processes of care: time delays (min:sec)
Methodological detailshealth record review, consecutive in-hospital cardiac arrest (IHCA)
- Health record review
- Consecutive IHCA
Main finding
As reported in the abstract
| Group | Start of chest compressions | Team arrival | 1st rhythm analysis | 1st epinephrine | Airway insertion |
|---|---|---|---|---|---|
| Before | 0:17 | 0:43 | 1:15 | 3:44 | 8:38 |
| After | 0:37 | 1:21 | 3:16 | 4:34 | 10:18 |
Start of chest compressions
Before0:17
After0:37
Team arrival
Before0:43
After1:21
1st rhythm analysis
Before1:15
After3:16
1st epinephrine
Before3:44
After4:34
Airway insertion
Before8:38
After10:18
Observational data: associations, not effects.
Further findings
Resuscitation duration (min:sec)
- Similar, before vs after: 18:28 vs 19:35
- P = 0.34
Peri-shock pause (min:sec)
- Appeared longer, before vs after: 0:06 vs 0:14
- P = 0.07
Chest compression fraction, rate and depth
- Identical and good in both periods
Factors independently associated with survival
- Age, adjOR 0.98
- P < 0.001
- Male sex, adjOR 1.51
- P = 0.048
- Witnessed, adjOR 2.35
- P = 0.02
- Shockable rhythm, adjOR 3.31
- P < 0.0001
- Hospital location
- P = 0.0002
- COVID-19 period, adjOR 0.68
- P = 0.052
Original publication
Impact of a COVID-19 code blue protocol on resuscitation care and CPR quality during in-hospital cardiac arrest. Resuscitation. Published 9 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it