[Analysis of response reports of an in-hospital emergency team : Three years experience at a maximum medical care hospital].

BACKGROUND: In-hospital emergencies can lead to unexpected admission to the ICU, cardiac arrest or even death. Therefore, hospitals have to implement an adequate in-hospital emergency management. The results of the deployment of the in-hospital emergency team of a hospital providing maximum medical care will be presented. PATIENTS AND METHODS: In 2003 the Westpfalz-Klinikum, Kaiserslautern introduced a central emergency team. The data of the emergency teams on alarm calls and the patient records from 2004 to 2007 were evaluated.
RESULTS: There were 241 alarm calls (9 alarm calls/100 beds and year). The mean age of the patients was 67 years and 56% were male. In 79% of all alarm calls the vital functions were compromised and in 37% cardiac arrest had occurred. When the emergency team arrived all cardiac arrest patients had received basic life support, however, no early defibrillation had been applied. On arrival of the emergency team 41% of the patients could be left on-site after emergency treatment, 40% had to be admitted to an intensive care or intermediate care unit and 21% died or were already dead (5 patients). In 27% of all cardiac arrests ventricular fibrillation/pulseless ventricular tachycardia was the first detected sign. Restoration of spontaneous circulation could be established in 53% and 20% of all resuscitated patients could be discharged. Respiratory emergencies (21%) and altered states of consciousness (20%) were other leading causes for calling the emergency team.
CONCLUSIONS: The high proportion of patients in a life-threatening condition and cardiac arrests indicates the necessity for closer patient monitoring, more intensive emergency training including early defibrillation and continuing education of hospital staff in the prevention and early detection of emergencies, in addition to the provision of an emergency team.