The Impact of Modern Call Response Systems on Return of Spontaneous Circulation in Blue Code Applications: A Prospective Observational Study

Abstract Background Cardiopulmonary arrest represents one of the most time-sensitive emergencies in healthcare settings. The Blue Code system serves as an early warning mechanism for cardiac arrest situations. This study aims to compare the effectiveness of traditional telephone-based (2222) Blue Code activation versus smart nurse call systems in terms of response times and patient outcomes. Methods This prospective observational study was conducted at Istanbul Başakşehir Çam and Sakura City Hospital between July 1, 2021, and December 31, 2021. A total of 620 patients were included: 312 in the traditional telephone system group (Group 1) and 308 in the smart nurse call system group (Group 2). Primary outcomes included response times, return of spontaneous circulation (ROSC), and survival rates. Results Smart nurse call systems achieved significantly better response times with 76% of teams arriving within 3 minutes compared to 50% in the traditional system (p < 0.001). ROSC rates were significantly higher in Group 2 (38.3% vs 28.5%, p = 0.008). Hospital discharge survival (18.8% vs 10.9%, p = 0.005), 30-day survival (16.6% vs 9.0%, p = 0.004), and neurological survival (14.0% vs 7.1%, p = 0.006) were all significantly improved with smart systems. Conclusions Smart nurse call systems demonstrate superior performance in Blue Code applications, with significant improvements in response times, call accuracy, and patient survival outcomes. These findings support the adoption of modern communication technologies in hospital emergency response systems.