Delayed response times

Hospitals need to find ways to respond more quickly to patients in cardiac arrest

Sunday, Jan. 6, 2008 | midnight

A study published Thursday in the New England Journal of Medicine shows that hospitals can be slow to respond to patients who suffer cardiac arrest.

Researchers studied more than 6,700 cases in which a defibrillator could have been used to try to restart a hospital patient's heart. Guidelines call for defibrillators to be used within two minutes, but the study of 369 hospitals found that in 30 percent of the cases it took longer than that to administer the shock.

The study found that in cases in which the shock was given within two minutes, nearly 40 percent of the patients recovered enough to eventually be discharged. Only 22 percent of those who received the shock after two minutes survived long enough to leave the hospital.

Dr. Paul S. Chan of Saint Luke's Mid-America Heart Institute in Kansas City, Mo., the study's lead author, said the problem for the delays can be staffing -- the study found delays were more likely on weekends and at night -- or hospital procedures. Some hospitals require a doctor to be present before a shock is administered.

In an editorial that ran with the study, Dr. Leslie Saxon, the chief of cardiology at the University of Southern California, argued that hospitals could be doing more to increase response times to cardiac arrests.

“It is probably fair to say that most patients assume -- unfortunately, incorrectly -- that a hospital would be the best place to survive a cardiac arrest,” Saxon wrote in an editorial that accompanied the study.

She said hospitals could do more heart monitoring of patients and install easy-to-use automatic defibrillators in rooms. Such defibrillators, which can be used by laymen, have been installed at airports, casinos and other public places and are credited with saving lives.

Saxon told The New York Times that “you're better off having your (cardiac) arrest at Nordstrom, where I'm standing right now, because there are 15 people around me.”

What a sad comment. Hospitals should take note and make every effort to improve.