Tuesday February 21, 2006
Shock alert - Shock bed
In nontraumatic shock, timing is everything as proved again by this organized hospital approach from Dr. Sebat and coll.
As a first step of program - 2.5 years of planning and 1 month of intensive education done for early recognition and treatment of shock. Prehospital personnel, nurses, and physicians were empowered to mobilize a Shock Alert depending on screening criteria. Shock bed was made available in ICU all the time. (please see article below for full inclusion, exclusion criteria and protocol details). In second phase, 86 and 103 patients were randomized to the control and protocol groups. The protocol group had significant reductions in the median times to interventions, as follows:
intensivist arrival time - decreased from 120 minutes to 50 minutes
ICU admission - decreased from 167 minutes to 90 minutes
2 L fluid infused - decreased from 232 minutes to 105 minutes
Pulmonary artery catheter placement - decreased from 230 minutes to 130 minutes
Result: The hospital mortality rate was 40.7% in the control group and 28.2% in the protocol group (p = 0.035).
Reference: Click to get abstract/article
A Multidisciplinary Community Hospital Program for Early and Rapid Resuscitation of Shock in Nontrauma Patients - Chest. 2005;127:1729-1743