Intended for healthcare professionals

Rapid response to:


Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study

BMJ 2002; 324 doi: (Published 16 February 2002) Cite this as: BMJ 2002;324:387

Rapid Response:

Questions regarding reduced incidence and of mortality from unexpected cardiac arrest

Dear Editor:

As usual, you publish interesting and medically challenging studies
such as the paper on "Effects of emergency medical team on reduction of
and mortality from unexpected cardiac arrest in hospital:Preliminary
study" Buist DM et al,BMJ 2002; 324: 387-390.
Permit me to raise the followiong questions: 1- The admitted to hospital
"cases" in 1996 and in 1999 included one case re- admitted twice or more
than twice within a period of one week-four weeks or more after discharge
or the "cases" refer to individual and different patients? as when
mortality figures were given.

2- What was the survival rate(No/time span) of those patients that
survived beyound hospitalization without expert intervention in 1996,in
comparison to expert intervention survival of patients in 1999?

3- The authors' paper rests on unexpected cardiac arrest expert
emergency intervention, does that imply that basically the cases or
patients (whatever the label may have been) did not have cardiac disease
or serious cardiac disease or respiratory disease, or metabolic disease?

4-Another important question is the etiology of the diseases
rather than the conglomeration of symptoms vis a vis intervention or not
for survival or lack thereof in each group(1996,& 1999) and whether
there is a correlation in the diseases of each group and sub entity that
led to success or failure of survival, such an approach would better
define (un)expected cardiac arrest.

5- Am I correct in assuming that the expertise in the emergency
intervetionalist was the at same level in 1996 & 1999, baring new
technologies? and that the patients admitted were cared for in the
hospital by the same group
or a different group of doctors?

Munir E Nassar, M.D.

Competing interests: No competing interests

22 July 2002
Munir E mile Nassar, M.D.
consultant cardiologist
17 Cobblefield Way, Pittsford, NY USA 14534