Identifying the general ward patient at high risk of cardiac arrest

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Abstract
Objective: A study was undertaken to determine the incidence of antecedent factors leading to hospital inpatient cardiorespiratory arrests. Design: Review of medical records over five randomly selected 24-hour periods to identify signs known to be antecedents to cardiorespiratory arrest. Setting: General wards of a 460-bed Australian teaching hospital. Interventions: None. Measurements and main results: Of the 1,027 charts reviewed, nine (0.88%) were identified as having signs thought to proceed to cardiac arrest. Systolic blood pressure was less than 90 mmHg in three cases, pulse rate was 140 bpm in one patient and respiratory rate was 36 breaths/min in five patients. Conclusions: Signs which have been reported as antecedent factors leading to cardiorespiratory arrest are of sufficient frequency in the general hospital population to make it feasible to institute a standardised, team-based urgent response.

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