Approximately 35% of adult in-hospital cardiac arrests occur in general wards, with many being preventable due to deficiencies in patient assessment and recognition of warning signs. Significant percentages of warning signs were either not recognized or acted upon, and there was inadequate communication with senior doctors prior to arrests. Unplanned ICU admissions have been linked to higher hospital mortality rates over the years examined.

2. How prevalent are cardiac arrests?
As high as 35% of all adult in-hospital
cardiac arrests happen in general
wards. (45% ICU, 11% A&E)
From the National registry of CPR (US & Canada), 253 hospitals, 2000 – 2004.
Nadkarni et al. JAMA 2006; 295: 50-57

3. 1/3 of in-hospital cardiac arrests & subsequent
attempts to resuscitate could have been
prevented
• patient assessment deficient – 47%
• warning signs of deteriorating – 75%
• warning signs not recognised – 35%
• not acted on – 56%
• not communicated to senior doctors – 55%
• lack of input from senior clinicians in the 48-hours prior
to cardiac arrest.
National Confidential Enquiry into Patient Outcome and Death (NCEPOD) 2012

5. Unplanned ICU admissions have higher hospital
mortality
Planned Unplanned
Group
0
100
200
300
400
Count
Mortality
Yes
No

10. 2009 2010 2011 2012 2013
%unplanned/total
MICU (transfers in) &
HDU adm
36.9 33.3 19.0 27.0 15.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
%
%unplanned/total MICU (transfers in)
& HDU adm2009 2010 2011 2012 2013
MET 66 69 209 238 264
66 69
209
238
264
0
50
100
150
200
250
300
No.ofMETactivations MET