In-hospital resuscitation: association between ACLS training and survival to discharge.

Abstract

No data have been published on the relationship between advanced cardiac life support (ACLS) training of the individual who initiates resuscitation efforts and survival to discharge. To determine whether patients whose arrests were discovered by nurses trained in ACLS had survival rates different from those discovered by nurses not trained in ACLS. Cohort case-comparison. A 550-bed, tertiary care center in central Georgia. Patients whose cardiopulmonary arrest was discovered by a nurse who activated the in-hospital resuscitation mechanism. Patient survival to discharge. Initial rhythm was strongly related to survival to discharge and individually associated with 57% of the variability in survival. Nurse's training in advanced cardiac life support was also strongly related to survival and individually associated with 29% of the variability. Combining both the variables determined 62% of the variability in survival to discharge. Patients discovered by an ACLS-trained nurse (n=88) were about four times more likely to survive (33 survivors, 38%) than were patients, discovered by a nurse without training in ACLS (n=29, three survivors, 10%). Arrest discovery by nurses trained in ACLS is significantly and dramatically associated with higher survival-to-discharge rates.