Code Blue: methodology for a qualitative study of teamwork during simulated cardiac arrest.

IntroductionIn-hospital cardiac arrest (IHCA) is a particularly vexing entity from the perspective of preparedness, as it is neither common nor truly rare. Survival from IHCA requires the coordinated efforts of multiple providers with different skill sets who may have little prior experience working together. Survival rates have remained low despite advances in therapy, suggesting that human factors may be at play.Methods and analysisThis qualitative study uses a quasiethnographic data collection approach combining focus group interviews with providers involved in IHCA resuscitation as well as analysis of video recordings from in situ-simulated cardiac arrest events. Using grounded theory-based analysis, we intend to understand the organisational, interpersonal, cognitive and behavioural dimensions of IHCA resuscitation, and to build a descriptive model of code team functioning.Ethics and disseminationThis ongoing study has been approved by the IRB at UC Davis Medical Center.ResultsThe results will be disseminated in a subsequent manuscript

Code Blue on Orbit: Treating Cardiac Arrest on the ISS

As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program

2016 Annual Report on the State of Homelessness in WNY

The Homeless Alliance of Western New York is the designated Continuum of Care (CoC) agency for Erie County that is responsible for compiling the annual Continuum of Care grant from the Department of Housing and Urban Development (HUD). In 2011 this grant awarded $11.2 million in funding for new and renewal projects to homeless agencies throughout Erie County

Patient Safety Initiative : Web based Education on the VCUHS Code Carts

We developed standardized web based learning modules on the VCUHS adult and pediatric code carts that enables health care providers in an organization to receive standardized training that is readily accessible to improve retention of the items and their location in the code carts

Prevalence and Seven-day Observation of Critically Ill Patients in Cipto Mangunkusumo Hospital, Jakarta: a Preliminary Study

Current medical record system in Cipto Mangunkusumo Hospital (RSCM) does not allow up-to-dateidentification for patients with critical condition. As an effort on improving the rapid response of themedical team, this study aims to determine the number of critically ill patients and the incidence ofemergency activation (code blue) during the study period. A longitudinal study was conducted for allinpatients that were critically ill in RSCM ward from 19th to 26th April 2013. Via consecutive sampling,critically ill patients were selected based on the code blue criteria. Selected patients were then observedfor seven days to determine the incidence of cardiopulmonary arrest and their 24-hour survival. Outof 428 patients who were treated in the hospital ward on 19th April 2013, 13 patients (3%) were incritical condition. Primary diagnoses of the critically ill patients varied from infections, auto-immune tomalignancies. Four deaths occurred with three emergency activations; 1 central and 2 regional. Threepercent of all the inpatients treated in the hospital ward were critically ill. Thirty percent of those patientexperienced cardiac arrests. All four arrests resulted in deaths, including two do not resuscitate patients.Data obtained from this study are preliminary and has identified existing problems that requires furtherstudies for confirmation. This study also illuminate the importance of integrated-electrical medicalrecord system

Life, Life Support, and Death Principles, Guidelines, Policies and Procedures for Making Decisions That Respect Life

The following is the third edition of a booklet by the American Life League, Inc. The section on Ordinary/Extraordinary Means has been revised. The sections on Quality of Life, Pain, Paired Organ and Non-vital Organ and Tissue Transplant, and Determination of Death have been added. There are other changes throughout the booklet