McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
ICU & Emergencies
EMS and prevention of in-hospital cardiac arrests

EMS and prevention of in-hospital cardiac arrests

2018-08-21

Bernd W. Böttiger

Recorded at the 4th McMaster International Review Course in Internal Medicine (MIRCIM).

What is the role of emergency medical services in preventing in-hospital cardiac arrest?

Bernd W. Böttiger, MD: I think medical emergency teams are very important to further increase survival in our in-hospital cardiac arrest patients. We have been recommending medical emergency teams in our guidelines since 2015 and we have several studies suggesting that these teams are very important.

In Germany we started to implement these medical emergency teams in hospitals, and we have data that in those hospitals where we have established these teams, the in-hospital cardiac arrest rate is 50% as compared to hospitals where we do not have medical emergency teams. That is a good signal and supports the introduction of these teams. They do not go to a patient who is in cardiac arrest, they come to the patient on the “peripheral” [regular] ward much earlier, and the patients have the chance not to go into cardiac arrest, which is the best therapy they can receive.

See also

First steps in suspected sepsis What should be our first steps when we suspect sepsis?
Transporting patients during CPR Should patients with out-of-hospital cardiac arrest and suspected myocardial infarction or pulmonary embolism be transported to the hospital while being resuscitated? Should Advanced Life Support interventions be prolonged in such cases?
Prehospital management of COPD exacerbations by EMS What are the current recommendations for prehospital management of patients with exacerbations of chronic obstructive pulmonary disease (COPD) by emergency medical services?
Fluid resuscitation in the early management of septic shock What are the current guidelines for fluid resuscitation in the early management of patients with septic shock?
Recruitment maneuvers and high PEEP during mechanical ventilation in ARDS What is the role of recruitment maneuvers and high positive end-expiratory pressure (PEEP; “open lung strategy”) during mechanical ventilation in patients with acute respiratory distress syndrome?
Headache: when to worry A lecture by Prof. Wieslaw Oczkowski, from McMaster University, Canada, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.
Cardiopulmonary resuscitation and emergency cardiovascular care: key messages from new guidelines A lecture by Prof. Bernd W. Böttiger, from University Hospital Cologne, Germany, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

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