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A call for 2222 in European hospitals—A reply to letter by Dr. Whitaker
Resuscitation 107 (2016) e19
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor A call for 2222 in European hospitals—A reply to letter by Dr. Whitaker Sir, We have with great interest read the letter by Dr. Whitaker on a standardized cardiac arrest call telephone number for all European hospitals.1 A standardized telephone number to summon the cardiac arrest team is suggested to improve patient safety. However, the possible impact of standardizing the hospital cardiac arrest telephone number on hospital staff awareness is unknown. Recently, we conducted a nationwide survey in all public Danish hospitals using telephone interviews with physicians on cardiac arrest teams. Physicians were inquired about the cardiac arrest telephone number in their hospital. Subsequently, each hospital was contacted to validate the cardiac arrest telephone number. In Denmark, cardiac arrest teams generally consist of one or more physicians, nurses and orderlies.2 We interviewed 90 physicians (response rate: 100%) in 43 hospitals. One physician was excluded from data analysis because the hospital in which this physician worked did not have a cardiac arrest telephone number. Overall, 30% of physicians did not know the cardiac arrest telephone number. Moreover, 25% stated an incorrect number while 45% stated the correct number. In Denmark, 26 different cardiac arrest telephone numbers were used in 41 hospitals (of 42), whereas 1 hospital used several different numbers specific for each department. In one Danish region, all hospitals (n = 11, physicians interviewed: 23) used one number (2222). Interestingly, more physicians (78%) in this region were able to state the correct cardiac arrest telephone number compared with 33% in regions not using a standardized number (p < 0.001, chi squared test). Our survey has a number of limitations; the survey included only cardiac arrest team physicians, while calling the cardiac arrest team is often performed by ward personnel. The awareness of the cardiac arrest telephone number may be lower in an “unselected” group of hospital staff. In addition, the survey includes a limited sample size. Nonetheless, our data suggest that standardizing the cardiac arrest telephone number may improve awareness. Our findings also indicate that standardizing cardiac arrest telephone numbers are under-prioritized. Barriers for implementing a standardized telephone number may include lacking knowledge of recommendations,3,4 technical and financial issues and local politics. The financial costs of standardization are unknown and may far exceed the estimated 7.500 Euros per hospital.4 Careful analysis of the financial implications of standardization is needed. Hospital administrators and opinion makers may argue that the clinical impact of standardizing the cardiac arrest telephone number is unknown. Standardizing cardiac arrest telephone numbers seems logical in order to improve patient safety. Universal knowledge of the
http://dx.doi.org/10.1016/j.resuscitation.2016.07.245 0300-9572/© 2016 Elsevier Ireland Ltd. All rights reserved.
cardiac arrest team telephone number may counter delayed cardiac arrest team activation and advanced life support. We support Dr. Whitaker’s assiduity in promoting a European in-hospital cardiac arrest telephone number. We would however welcome any data documenting a clinical effect of standardizing the cardiac arrest telephone number which would possibly help excel standardization. Meanwhile, we suggest that inexpensive self-adhesive stickers with current hospital cardiac arrest telephone number become mandatory on all static and mobile telephones used inhospital and preferably widely disseminated e.g., on the reverse side of staff identification cards. Conflict of interest statement None to declare. References 1. Whitaker DK. Establishing a standard Cardiac Arrest Call telephone number for all hospitals in Europe—2222. Resuscitation 2016;105:e25. 2. Lauridsen KG, Schmidt AS, Adelborg K, Lofgren B. Organisation of in-hospital cardiac arrest teams—a nationwide study. Resuscitation 2015;89:123–8. 3. Soar J, Nolan JP, Bottiger BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 2015;95:100–47. 4. European Board of Anaesthesiology. The European Board of Anaesthesiology recommends a standard Cardiac Arrest call telephone number in European hospitals; 2015. http://www.eba-uems.eu/resources/PDFS/safety-guidelines/ EBA-recommendation-on-standardised-cardiac-arrest-call-no-Nov-2015.pdf [accessed 18.07.16].
Kasper Glerup Lauridsen a,b,∗ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark b Clinical Research Unit, Regional Hospital of Randers, Randers, Denmark a
Bo Løfgren a,b,c Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark b Department of Internal Medicine, Regional Hospital of Randers, Randers, Denmark c Institute of Clinical Medicine, Aarhus University, Denmark a
∗ Corresponding author at: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 1st Floor, 8000 Aarhus, Denmark. E-mail address: [email protected] (K.G. Lauridsen)
30 July 2016
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor A call for 2222 in European hospitals—A reply to letter by Dr. Whitaker Sir, We have with great interest read the letter by Dr. Whitaker on a standardized cardiac arrest call telephone number for all European hospitals.1 A standardized telephone number to summon the cardiac arrest team is suggested to improve patient safety. However, the possible impact of standardizing the hospital cardiac arrest telephone number on hospital staff awareness is unknown. Recently, we conducted a nationwide survey in all public Danish hospitals using telephone interviews with physicians on cardiac arrest teams. Physicians were inquired about the cardiac arrest telephone number in their hospital. Subsequently, each hospital was contacted to validate the cardiac arrest telephone number. In Denmark, cardiac arrest teams generally consist of one or more physicians, nurses and orderlies.2 We interviewed 90 physicians (response rate: 100%) in 43 hospitals. One physician was excluded from data analysis because the hospital in which this physician worked did not have a cardiac arrest telephone number. Overall, 30% of physicians did not know the cardiac arrest telephone number. Moreover, 25% stated an incorrect number while 45% stated the correct number. In Denmark, 26 different cardiac arrest telephone numbers were used in 41 hospitals (of 42), whereas 1 hospital used several different numbers specific for each department. In one Danish region, all hospitals (n = 11, physicians interviewed: 23) used one number (2222). Interestingly, more physicians (78%) in this region were able to state the correct cardiac arrest telephone number compared with 33% in regions not using a standardized number (p < 0.001, chi squared test). Our survey has a number of limitations; the survey included only cardiac arrest team physicians, while calling the cardiac arrest team is often performed by ward personnel. The awareness of the cardiac arrest telephone number may be lower in an “unselected” group of hospital staff. In addition, the survey includes a limited sample size. Nonetheless, our data suggest that standardizing the cardiac arrest telephone number may improve awareness. Our findings also indicate that standardizing cardiac arrest telephone numbers are under-prioritized. Barriers for implementing a standardized telephone number may include lacking knowledge of recommendations,3,4 technical and financial issues and local politics. The financial costs of standardization are unknown and may far exceed the estimated 7.500 Euros per hospital.4 Careful analysis of the financial implications of standardization is needed. Hospital administrators and opinion makers may argue that the clinical impact of standardizing the cardiac arrest telephone number is unknown. Standardizing cardiac arrest telephone numbers seems logical in order to improve patient safety. Universal knowledge of the
http://dx.doi.org/10.1016/j.resuscitation.2016.07.245 0300-9572/© 2016 Elsevier Ireland Ltd. All rights reserved.
cardiac arrest team telephone number may counter delayed cardiac arrest team activation and advanced life support. We support Dr. Whitaker’s assiduity in promoting a European in-hospital cardiac arrest telephone number. We would however welcome any data documenting a clinical effect of standardizing the cardiac arrest telephone number which would possibly help excel standardization. Meanwhile, we suggest that inexpensive self-adhesive stickers with current hospital cardiac arrest telephone number become mandatory on all static and mobile telephones used inhospital and preferably widely disseminated e.g., on the reverse side of staff identification cards. Conflict of interest statement None to declare. References 1. Whitaker DK. Establishing a standard Cardiac Arrest Call telephone number for all hospitals in Europe—2222. Resuscitation 2016;105:e25. 2. Lauridsen KG, Schmidt AS, Adelborg K, Lofgren B. Organisation of in-hospital cardiac arrest teams—a nationwide study. Resuscitation 2015;89:123–8. 3. Soar J, Nolan JP, Bottiger BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 2015;95:100–47. 4. European Board of Anaesthesiology. The European Board of Anaesthesiology recommends a standard Cardiac Arrest call telephone number in European hospitals; 2015. http://www.eba-uems.eu/resources/PDFS/safety-guidelines/ EBA-recommendation-on-standardised-cardiac-arrest-call-no-Nov-2015.pdf [accessed 18.07.16].
Kasper Glerup Lauridsen a,b,∗ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark b Clinical Research Unit, Regional Hospital of Randers, Randers, Denmark a
Bo Løfgren a,b,c Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark b Department of Internal Medicine, Regional Hospital of Randers, Randers, Denmark c Institute of Clinical Medicine, Aarhus University, Denmark a
∗ Corresponding author at: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 1st Floor, 8000 Aarhus, Denmark. E-mail address: [email protected] (K.G. Lauridsen)
30 July 2016