The following is a summary of “Impact of the hybrid emergency department on Resuscitation Strategies and Outcomes in ventricular fibrillation,” published in the November 2023  issue of Emergency Medicine by Mitsuhara, et al.

The Hybrid emergency room (ER) is a new resuscitation room with a whole-body computed tomography machine and an angiography system. This lets doctors do resuscitation, evaluation, and treatment without moving the patient. For a study, researchers sought to find out how the Hybrid ER affected death rates in people who had ventricular fibrillation heart arrest. A group study that looked back was done in a major hospital. They looked at all the adult cardiac arrest patients who were taken to emergency rooms between January 2007 and May 2020 and were proven to be in ventricular fibrillation within 10 minutes of arriving at the hospital. 

The people in the study were split into two groups: the standard group, which met from January 2007 to July 2011, and the Hybrid ER group, which met from August 2011 to May 2020. All-cause death in the hospital was set as the main outcome of this study. Extracorporeal cardiac resuscitation (ECPR) and percutaneous coronary intervention (PCI) rates, as well as the time from door to balloon and door to ECPR, were used as secondary outcomes. In their study, 115 patients were in the traditional group and 185 patients were in the Hybrid ER group. 

The Hybrid ER group had a much lower risk of dying in the hospital (adjusted hazard ratio, 0.79; 95% CI 0.64–0.97; P = 0.026). There was a big difference between the Hybrid ER group and the other groups in the time it took to go from the door to ECPR and the time it took to go from the door to the balloon (P = 0.004, Gehan-Breslow-Wilcoxon test). In discontinuous time-series studies, it was clear that the number of patients who got both ECPR and PCI went up, and the times it took to go from the door to ECPR and the door to balloon were reduced from 2011 to 2012 (before and after the Hybrid ER was installed). Putting in the Hybrid ER was linked to a shorter time between ECPR and PCI and a possible rise in survival rates in people who had ventricular fibrillation cardiac arrest.

Source: sciencedirect.com/science/article/abs/pii/S0735675723003832