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International Journal for Quality in Health Care Advance Access originally published online on October 24, 2006
International Journal for Quality in Health Care 2006 18(6):446-451; doi:10.1093/intqhc/mzl056
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International Journal for Quality in Health Care vol. 18 no. 6 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Increase in rapid defibrillation programmes after publication of guidelines

Jouni Nurmi1, Markus B. Skrifvars2, Per H. Rosenberg1 and Maaret Castrén3

1 Department of Anaesthesiology and Intensive Care Medicine, 2 Department of Anaesthesiology and Intensive Care Medicine, Helsinki EMS, and 3 Department of Anaesthesiology and Intensive Care Medicine, Uusimaa EMS, Helsinki University Hospital, Helsinki, Finland

Objectives. To monitor the implementation of in-hospital resuscitation strategies including (i) rapid defibrillation programmes, (ii) the use of amiodarone for prolonged ventricular fibrillation, and (iii) uniform data collection on resuscitation, all recommended by international guidelines published in 2000 and by Finnish national resuscitation guidelines published in 2002.

Design. In 2004, a questionnaire was sent to the chief anaesthesiologists. The results were compared with those of a previous study performed using similar methods in 2000.

Setting. All public hospitals that provide anaesthetic services in Finland.

Main outcome measures. Number of hospitals allowing nurses to perform defibrillation without the presence of physician and number of hospitals using amiodarone as primary antiarrhythmic drug in resuscitation and performing uniform data collection.

Results. The response rate was 95% (52/55). The proportion of the hospitals with rapid defibrillation programmes on general wards had increased from 15% in 2000 to 67% in 2004, and most (79%) hospitals had obtained automated external defibrillators. Amiodarone was used in 88% of the hospitals. Data collection of resuscitation attempts using definitions provided in the Utstein guidelines was performed only in 22% of the hospitals.

Conclusions. Rapid defibrillation programmes have markedly increased, and the use of amiodarone has been established in Finnish hospitals since the publication of the international and the national resuscitation guidelines.

Keywords: cardiopulmonary resuscitation, defibrillators, guidelines, nurses

Address reprint requests to Jouni Nurmi, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. E-mail: jouni.nurmi{at}helsinki.fi

Accepted for publication September 25, 2006.


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