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

Context: No data have been published on the relationship between advanced c ardiac life support (ACLS) training of the individual who initiates resusci tation efforts and survival to discharge. Objective: To determine whether p atients whose arrests were discovered by nurses trained in ACLS had surviva l rates different from those discovered by nurses not trained in ACLS. Desi gn: Cohort case-comparison. Setting: A 550-bed, tertiary care center in cen tral Georgia. Subjects: Patients whose cardiopulmonary arrest was discovere d by a nurse who activated the in-hospital resuscitation mechanism. Main ou tcome measure: Patient survival to discharge. Results: Initial rhythm was s trongly related to survival to discharge and individually associated with 5 7% of the variability in survival. Nurse's training in advanced cardiac lif e support was also strongly related to survival and individually associated with 29% of the variability. Combining both the variables determined 62% o f the variability in survival to discharge. Patients discovered by an ACLS- trained nurse (n = 88) were about four times more likely to survive (33 sur vivors, 38%) than were patients, discovered by a nurse without training in ACLS (n = 29, three survivors, 10%). Conclusion: Arrest discovery by nurses trained in ACLS is significantly and dramatically associated with higher s urvival-to-discharge rates. (C) 2000 Elsevier Science Ireland Ltd. All righ ts reserved.