In-hospital cardiac arrest is not a sudden event. It is the final moment of a deterioration that was detectable — hours earlier — in the vital signs, the rhythm, the labs, and the clinical trajectory. Sentinel Cardiac sees what human eyes cannot process fast enough.
The word "arrest" implies something sudden. It is not. In 80% of in-hospital cardiac arrest cases, the patient showed detectable signs of physiological deterioration in the 6-8 hours preceding the event. Heart rate variability narrows. Blood pressure drifts. Respiratory patterns shift. Electrolytes trend into dangerous territory. QT intervals stretch. Lactate creeps. Individually, these signals are unremarkable. Together, they form a pattern that a machine learning model trained on millions of patient-hours can recognize with an AUC of 0.93 — hours before the monitor alarms, hours before the code blue is called, and hours before the brain begins dying from oxygen deprivation.
Sentinel Cardiac transforms in-hospital cardiac arrest from an emergency response event into a preventable condition. It continuously monitors every hospitalized patient's cardiac risk profile — rhythm, hemodynamics, electrolytes, medications, and physiological trajectory — and activates the rapid response team before the arrest, not after it. Because once the heart stops, the survival clock starts at 25% and drops with every passing minute.
Cardiac arrest has a timeline. It has precursors. It has a detectable signature. Sentinel Cardiac watches every second of it.
Each engine addresses a distinct domain of cardiac arrest prevention and management.
This is the core engine. It synthesizes 200+ continuous and intermittent clinical variables — heart rate variability (33 HRV measures from 5-minute ECG epochs), blood pressure trajectories, respiratory patterns, SpO2 trends, lactate trajectories, electrolyte shifts, medication effects, and nursing documentation — to generate a real-time cardiac arrest risk score for every monitored patient. The model achieves an AUC of 0.93 for predicting cardiac arrest within the next 0.5-24 hours, significantly outperforming the NEWS scoring system and MEWS.
When the risk score crosses a critical threshold, the system activates a graduated response: first notifying the bedside nurse, then the charge nurse, then triggering the rapid response team — with each escalation accompanied by a clinical summary of why the patient is deteriorating and what intervention is recommended.
Many cardiac arrests are preceded by arrhythmias that are detectable but not detected — because conventional telemetry alarms have been silenced, ignored, or overwhelmed by false positives. Sentinel Cardiac provides intelligent rhythm surveillance that classifies 16 distinct arrhythmia types with 99.2% accuracy, detects QT prolongation from medication effects (antipsychotics, fluoroquinolones, antiarrhythmics, antiemetics), identifies Brugada-pattern and long-QT variants, and flags the progression from benign PVCs to malignant ventricular arrhythmias. The system calculates corrected QT in real time with every medication change and alerts prescribers when QTc exceeds safe thresholds.
Electrolyte disturbances are one of the most preventable causes of cardiac arrest — and one of the most commonly missed. Hypokalemia, hyperkalemia, hypomagnesemia, and severe acid-base disturbances directly alter cardiac electrical conduction, predisposing to ventricular fibrillation, torsades de pointes, and asystole. Sentinel Cardiac continuously tracks electrolyte trends, correlates them with ECG changes (peaked T-waves, widened QRS, U-waves), and alerts clinicians to dangerous trajectories before levels reach critical thresholds. The system also monitors medication-induced electrolyte shifts — diuretics depleting potassium, ACE inhibitors raising it, insulin driving it intracellularly.
Medications cause or contribute to a significant proportion of in-hospital cardiac arrests — through QT prolongation, electrolyte disturbances, negative inotropy, or pro-arrhythmic effects. Sentinel Cardiac maintains a continuously updated pharmacovigilance database linking 200+ medications to cardiac arrest risk, monitors the patient's entire medication profile for dangerous combinations, calculates real-time QTc impact with every prescription change, and flags prescriptions that push cumulative cardiac risk above safe thresholds. The system pays particular attention to combinations that individually appear safe but together create lethal conditions — a fluoroquinolone plus an antiemetic plus hypokalemia from a diuretic, for example.
When Sentinel Cardiac predicts an impending arrest, the rapid response team needs to arrive prepared — not just fast. The system generates a clinical briefing that includes the patient's cardiac risk trajectory, current rhythm, vital sign trends, relevant labs, medications, the predicted arrest mechanism (shockable vs. non-shockable rhythm), and recommended interventions. This briefing reaches the RRT before they arrive at bedside, enabling them to prepare appropriate medications, request the correct equipment, and arrive with a plan rather than a blank slate.
When prevention fails and arrest occurs, CPR quality becomes the primary determinant of survival. Compression depth, compression rate, chest recoil, compression fraction (minimal interruptions), and ventilation rate must all remain within narrow ranges — and they frequently don't. Sentinel Cardiac integrates with defibrillator feedback systems and accelerometer sensors to provide real-time CPR quality metrics to the code team leader, voice-guided compression coaching, optimal pause timing for rhythm checks, and evidence-based defibrillation decisions (shock vs. continued CPR based on VF waveform analysis).
Return of spontaneous circulation is not recovery — it is the beginning of the second crisis. Post-cardiac arrest syndrome involves ischemia-reperfusion injury to every organ, myocardial stunning, systemic inflammation, and evolving brain injury. Sentinel Cardiac guides the post-ROSC phase: recommending targeted temperature management protocols, monitoring for rearrest (which occurs in 20% of ROSC patients within 48 hours), optimizing hemodynamics to protect the injured brain, and timing cardiac catheterization based on ECG findings and clinical trajectory.
After cardiac arrest with ROSC, the most agonizing question families and clinicians face is: will this person wake up? And if they do, will they be themselves? Current prognostication relies on a combination of clinical examination, EEG, imaging, and biomarkers — but no single test is definitive, and premature withdrawal of care based on inaccurate prognostication is a documented cause of preventable death. Sentinel Cardiac integrates daily neurofilament light (NFL) levels, neuron-specific enolase (NSE) at 72 hours, serial EEG patterns, CT brain imaging analysis (gray-to-white matter ratio), pupillary light reflex data, and somatosensory evoked potentials into a multimodal prognostic model that provides calibrated probability estimates of neurological recovery — helping clinicians and families make informed decisions while avoiding self-fulfilling prophecy.
Results from our deployed health systems.
Sentinel Cardiac was deployed across 6 hospitals with continuous monitoring of 2,400 beds. In the first year, the system generated 3,800 early warning alerts, of which 75% resulted in rapid response activation before arrest occurred. Code blue activations dropped 44%. Among the patients who did arrest, ROSC rates improved 28% due to the system's pre-arrival clinical briefings enabling prepared team responses. Neurologically favorable survival to discharge — the metric that truly matters — improved 22% compared to the pre-deployment period.
A cardiac step-down unit deployed Sentinel Cardiac's arrhythmia surveillance and medication risk engines across 48 monitored beds. The system identified 86 instances of drug-induced QT prolongation that exceeded safety thresholds — 34 of which involved medication combinations that individually appeared safe but together created dangerous synergies. Twelve patients had medications adjusted based on Sentinel alerts before arrhythmia occurred. The unit's rate of medication-related cardiac events dropped to zero over the 14-month observation period.
The neurocritical care team deployed the prognostication engine across all post-cardiac arrest patients. The system's multimodal analysis — integrating NFL, NSE, EEG, CT imaging, and clinical exam — provided families with calibrated probability estimates that were both more accurate and more transparent than traditional physician gestalt. In 8 cases over 12 months, the system's optimistic prognosis prevented premature withdrawal of life-sustaining treatment in patients who ultimately recovered meaningful neurological function. The attending neurointensivist described these as "8 people who would have died under our old approach."
We used to call rapid response teams after the patient was already circling the drain. Now we call them four hours earlier — when there's still time to prevent the arrest entirely. Our code rate dropped 44% in the first year. That's not an improvement in resuscitation. That's an elimination of the need for it.
The electrolyte engine caught something that would have killed my patient. She was on a loop diuretic, an SSRI, and a fluoroquinolone — each individually appropriate, but together they drove her potassium to 2.8 and her QTc to 540. Sentinel flagged it at QTc 490. We corrected it with IV magnesium and potassium before anything happened. Without that alert, she would have had torsades in the middle of the night.
Eight families were told their loved one had a meaningful chance of recovery when our old approach would have suggested otherwise. Eight people who are alive today, neurologically intact, because the prognostication engine integrated data that no single clinician could synthesize in real time. I have never used the word "miraculous" to describe a piece of software before. I'm using it now.
Schedule a clinical demonstration of Sentinel Cardiac — configured for your telemetry system, your patient population, and your rapid response protocols.