Abstract Rationale Prompt response to in-hospital cardiac arrests (“codes”) is crucial for improving mortality. Hospital systems have a variety of ways of activating the code response team. However, there are no studies that compare text-paging versus overhead-paging for alerting in-hospital cardiac arrest response teams. This retrospective study sought to determine if there was a difference in code-response quality with the switch from overhead-paging to text-paging code response team members. Methods On October 29, 2024, the hospital started using a smartphone app to text-page code team members in addition to overhead announcements; before this date, codes were announced via overhead pager primarily. All patients above the age of 18 with an in-hospital cardiac arrest on general care or stepdown inpatient floors from July 1, 2024 to June 30, 2025 were chart reviewed. Patients were stratified into overhead-page vs. text-page groups based on date of code. The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes included code length, if epinephrine was administered during the code, time to first epinephrine dose, and if epinephrine was administered within two minutes or five minutes. Demographic data from the two groups were compared using either a chi-squared test or a student’s T test. Outcomes were analyzed using logistic or linear regression modeling. Results There were 88 codes in the designated period; 54 of which were after the institution of the text-page system. There were no significant differences in race, sex, age, insurance, location of the arrest, or primary team between codes with vs. without text-pages. There was no significant difference in frequency of ROSC with the text-page system. Codes were longer in the text-page group, remaining significant after adjustment for patient age, location of code, and epinephrine administration (coefficient = 13.09, p = 0.006; adjusted coefficient = 6.73, p = 0.028). Epinephrine was more likely to be given in the text-page group; after adjustment for location and code length this association only trended towards significance (OR = 11.36, p = 0.028; adjusted OR 9.62, p = 0.051). Time to epinephrine administration did not differ significantly between the groups, nor did the proportion of codes with epinephrine given within the first two minutes or five minutes. Conclusions After the institution of a text-page code alert system, there was no apparent decline in quality, compared to the previous overhead-page system. Further research is needed to investigate if text-page systems provide any improvements in CPR quality and mortality. This abstract is funded by: None
Gross et al. (Fri,) studied this question.