The educational program included a redefining of roles for the participants on the code team, practice with mock code simulations, expanded documentation, and retrospective review of performance on all resuscitations with team members to promote continuous practice improvement. The centerpiece of the program is the Carmaforlife app which all team members use at all codes.
Research has shown that strict adherence to protocols for Advanced Cardiac Life support, which are established by the American Heart Association and updated regularly, produce optimal results from cardiac resuscitations. The app includes a series of timers which prompt the members of the code blue team to perform the correct steps at exactly the appropriate times. It includes a metronome for perfect pacing of chest compressions. The protocols for different types of cardiac arrests are listed in detail and interact with the timers to direct practitioners. The app helps the leader with suggestions for possible causes of the arrest which can be ruled out in order of probability and helps determine why the arrest has happened, leading to not just survival but an understanding of the originating cause which can be corrected. This helps get patients not just through the cardiac arrest, but on the road to cure and returning home. Finally as the code progresses, the app documents everything which is being done in real time replacing the inefficient and inaccurate manual process. The improved documentation adds accuracy to the medical record, and allows for detailed review of the performance of the team which can be used for process improvement.
Using the Carmaforlife app, survival of a cardiac arrest improved by 37%, from 57% to 78%. The number of patients who actually went home after having a cardiac arrest improved 64%, from 22% to 36%. By comparison, the national average for surviving an arrest is 56.7 percent. The average chance of surviving a cardiac arrest and living to be discharged home at an average American hospital is 18%, half the chance of going home from Bridgeport Hospital if one suffers a cardiac arrest. In addition to saving lives and returning this sickest group of patients to a normal life, Bridgeport hospital was recognized by the American Heart Association's "Get with the Guidelines" program with a gold medal for performance and documentation.
"This has been very rewarding work developing this program, and especially the Carmaforlife app," Mrs. Bindelglass said. "There are few things in all of medicine where the results are so apparent in actually saving lives and returning our sickest patients home to their loved ones. All of the resident physicians and critical care doctors and nurses have come to rely on this app and they know that in the most difficult and stressful situations they face it has made them better practitioners and they see the immediate results."
The Carmaforlife app works on both the Apple and Android platforms and on any phone or tablet, making it readily accessible to practitioners. It can be used not just in the hospital, but in the prehospital setting by paramedics in the field or even by corpsman in the military potentially saving lives on the battlefield.
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