EFFECTIVENESS OF VITAL SIGN OBSERVATIONS IN DETECTING CARDIOPULMONARY ARREST: A PROSPECTIVE OBSERVATIONAL STUDY

Main Article Content

Sayyeda Aisha Bahar
Fazal Rabi
Mahnoor Liaqat
Dure Nayab
Syeda Noor us Saba
Tauseef Hamid
Sadaf Wazir

Keywords

Cardiopulmonary Arrest, Vital Signs, Early Detection, Patient Outcomes

Abstract

Background: Cardiopulmonary arrest (CPA) is a condition that is fatal and requires immediate action to be taken by the medical practitioners. The opportunity to detect the disease in its early stage by monitoring the vital signs increases the probability of survival. This paper aims to determine the efficiency of the observations of the vital signs in the early detection of CPA among patients in DHQ Hospital, Mishti Mela Orakzai, KPK.


Objectives: The objectives of the study are to determine the role of vital sign monitoring in identifying the signs of cardiopulmonary arrest, identify the correlation between the abnormal vital signs and CPA development, and analyze the influence of early detection on the patient’s outcomes.


Study design: A prospective observational study


Place and duration of Study: DHQ Hospital, Mishti Mela Orakzai from jan 2023 to jan 2024


Methods: A prospective observational study was carried out in DHQ Hospital, Mishti Mela Orakzai on 100 patients for six months. The medical conditions included in this study were heart rate, respiratory rate, blood pressure, and oxygen saturation of patients admitted in the hospital. Data was taken at intervals of one hour. The main measure was the identification of the symptoms that may point to the development of cardiopulmonary arrest. Descriptive data analysis involved use of mean age, standard deviation, p-values and percentage to establish the level of significance.


Results: The mean age of the patients was 55. 3 years with SD of 12. 7. The prevalence of arrhythmias was 25%, non-steady respiratory rate 20%, hypertension 40%, and hypoxemia 18%. Cardiopulmonary arrest was identified in 10 patients, and 8 of 10 patients had abnormal vital signs before the arrest. The ability to identify the problem early made it possible to revive the patient in 60% of the cases. The p-value for the correlation between abnormal vital signs and CPA was 0. 03 which is less than the significance level of 0. 05.


Conclusion:  Supravital assessment helps in identifying early signs of cardiopulmonary arrest and thus helps in early intervention thus enhancing the patient’s status. Therefore, constant supervision and immediate intervention when deviations are detected are vital in the management of CPA. More studies should be conducted with a larger sample size to confirm these results.

Abstract 93 | PDF Downloads 24

References

1. Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation. 2015 Oct;95:100-147.
2. Goldberger ZD, Chan PS, Berg RA, et al. Duration of resuscitation efforts and survival after in-hospital cardiac arrest: an observational study. Lancet. 2012;380(9852):1473-1481.
3. Chen LM, Nallamothu BK, Spertus JA, et al. Association between a hospital's rate of cardiac arrest incidence and cardiac arrest survival. JAMA Intern Med. 2013;173(13):1186-1195.
4. 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(1):50-57.
5. Girotra S, Nallamothu BK, Spertus JA, et al. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367(20):1912-1920.
6. Kollef MH, Canfield DA, Zuckerman GR. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999;115(2):462-474.
7. Kause J, Smith G, Prytherch D, et al. A comparison of antecedents to cardiac arrests, deaths, and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom—the ACADEMIA study. Resuscitation. 2004;62(3):275-282.
8. Goldhill DR, Worthington L, Mulcahy A, Tarling M, Sumner A. The patient-at-risk team: identifying and managing seriously ill ward patients. Anaesthesia. 1999 Sep;54(9):853-860.
9. Franklin C, Mathew J. Developing strategies to prevent in-hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994 Feb;22(2):244-247.
10. Jones D, Bates S, Warrillow S, et al. Effect of an education programme on the utilization of a medical emergency team in a teaching hospital. Intern Med J. 2006 Apr;36(4):231-236.
11. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: a preliminary study. BMJ. 2002 May 4;324(7334):387-390.
12. Ludikhuize J, de Jonge E, Goossens A, et al. Measuring adherence among nurses to a medical emergency team protocol. Intensive Care Med. 2012 Jul;38(7):1201-1206.
13. Cretikos MA, Bellomo R, Hillman K, et al. Respiratory rate: the neglected vital sign. Med J Aust. 2008 Jun 2;188(11):657-659.
14. Kause J, Smith G, Prytherch D, et al. A comparison of antecedents to cardiac arrests, deaths, and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom—the ACADEMIA study. Resuscitation. 2004 Sep;62(3):275-282.
15. Goldhill DR, McNarry AF. Physiological abnormalities in early warning scores are related to mortality in adult inpatients. Br J Anaesth. 2004 Aug;92(5):778-784.
16. Churpek MM, Yuen TC, Park SY, Meltzer DO, Hall JB, Edelson DP. Using electronic health record data to develop and validate a prediction model for adverse outcomes in the wards. Crit Care Med. 2014 Apr;42(4):841-848.
17. Kyriacos U, Jelsma J, Jordan S. Monitoring vital signs using early warning scoring systems: a review of the literature. J Nurs Manag. 2011 Mar;19(3):311-330.
18. Tirkkonen J, Tamminen T, Skrifvars MB. Outcome of adult patients attended by rapid response teams: a systematic review of the literature. Resuscitation. 2013 Jun;84(6):724-731.
19. Peberdy MA, Ornato JP, Larkin GL, et al. Survival from in-hospital cardiac arrest during nights and weekends. JAMA. 2006 Feb 22;295(7):802-804.
20. Churpek MM, Yuen TC, Edelson DP. Risk stratification of hospitalized patients on the wards. Chest. 2014 Jun;145(6):1445-1451.
21. Andersen LW, Kim WY, Chase M, et al. The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation. 2019 Mar;137:68-73.