American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

‘Code Yellow’ team achieves 100 percent survival in electrophysiology complications cases

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday Second Edition

Teams implementing a multi-disciplinary “Code Yellow Cardiac” (CYC) rescue protocol to ensure prompt surgical intervention for electrophysiology (EP) laboratory patients developing critical complications achieved 100 percent survival, with all patients living to hospital discharge.

Researchers led by Salaam S. Sadi, MD, of MedStar Washington Hospital Center and Georgetown University School of Medicine, Washington, DC, reviewed records and outcomes of 15 EP complication cases over two years in which rescue was attempted by a responding CYC team. The team consisted of cardiac and/or trauma surgeons, trainees, and anesthesiology responding to personal and overhead pages for patients experiencing arrhythmia, tamponade, and cardiac arrest.

Patients were predominantly male (53.3 percent) and Caucasian (53.3 percent), with mean age 70±13 years. The most common EP procedure performed was ablation (66.7 percent). Code findings included hypotension (46.7 percent), effusion (46.7 percent), and cardiac arrest (6.7 percent). Eight patients required emergent intervention, including pericardiocentesis (7), transvenous pacing (1), and chest tube placement (1). Following CYC, 10 patients were triaged to the ICU, two to the cardiac ward, and three were transported to the operating room for further intervention.  

The authors conclude that future work may focus on examining the applicability of the CYC protocol to other clinical settings.

Additional Information:

This Scientific Forum study was presented October 24 at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA.  Program, webcast and audio information is available online at

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