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Multidisciplinary Review of Code Events in a Heart Center.

Am J Crit Care

July 2016

Angela C. Blankenship is an advanced practice nurse, Nationwide Children's Hospital, Columbus, Ohio. Richard P. Fernandez, Brian F. Joy, Steven C. Cassidy, Janet Simsic, and Christina Phelps are pediatric cardiologists, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University, Columbus, Ohio. Julie C. Miller is a pharmacist and Aymen Naguib is a pediatric cardiac anesthesiologist, Nationwide Children's Hospital. Sheilah Harrison is a quality improvement specialist, Nationwide Children's Hospital. Mark Galantowicz is a cardiothoracic surgeon, Department of Surgery, The Ohio State University. Andrew R. Yates is a pediatric cardiologist and intensivist, Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital.

Objective: To identify a cause for clinical deterioration, examine resuscitation efforts, and identify and correct system issues (thus improving outcomes) via a multidisciplinary code-review process soon after cardiopulmonary arrest.

Methods: Retrospective analysis of code events in a tertiary pediatric heart center from September 2010 to December 2013 and review of surgical-cardiac data from January 2010 to December 2013.

Results: A multidisciplinary team reviewed 47 code events, 16 of which (34%) were deemed potentially preventable.

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