Variations in Hospitals’ Vital Times-to-Defibrillation

In our favorite TV dramas it only takes seconds to bring in the crash cart and apply to pads, so that defibrillation is done well within the recommended 2 minutes after cardiac arrest. Not so in real life, apparently. A study in the Archives of Internal Medicine examined hospital variation in defibrillation response times and the associated impact on survival.

Data were collected from 200 hospitals participating the American Heart Association National Registry of Cardiopulmonary Resuscitation. There were almost 7,500 cases of cardiac arrest. Delayed defibrillation was defined as more than 2 minutes from recognition of cardiac arrest to attempted defibrillation.  

The rates of delayed defibrillation ranged from 2% to 51% across the hospitals. Larger hospitals (‘bed volume’) tended to have lower rates of delayed resuscitation, but academic status and geographic location had no influence. Not surprisingly, lower rates of delayed defibrillation were associated with increased survival.  

This study has disclosed a considerable problem, without finding an easily-remedied cause. As improved survival is linked to reduced frequency of delayed defibrillation, further work should concentrate on finding the ‘success factor’ (or factors) in those large hospitals with good results.