Measuring and improving cardiopulmonary resuscitation quality inside the emergency department

被引：30

作者：

Crowe, Christopher ^{[1
]}

Bobrow, Bentley J. ^{[2
,4
]}

Vadeboncoeur, Tyler F. ^{[3
]}

Dameff, Christian ^{[1
]}

Stolz, Uwe ^{[4
]}

Silver, Annemarie ^{[5
]}

Roosa, Jason ^{[6
]}

Page, Rianne ^{[1
]}

LoVecchio, Frank ^{[1
]}

Spaite, Daniel W.

机构：

[1] Maricopa Cty Gen Hosp, Dept Emergency Med, Phoenix, AZ 85008 USA

[2] Arizona Dept Hlth Serv, Bur Emergency Med Serv & Trauma Syst, Phoenix, AZ 85007 USA

[3] Mayo Clin Florida, Dept Emergency Med, Jacksonville, FL 32224 USA

[4] Univ Arizona, Dept Emergency Med, Tucson, AZ 85724 USA

[5] ZOLL Med, Chelmsford, MA 01824 USA

[6] Lutheran Med Ctr, Wheat Ridge, CO 80033 USA

来源：

RESUSCITATION | 2015年 / 93卷

关键词：

Cardiac arrest; CPR; Resuscitation; Emergency medicine; CPR quality; CPR feedback; HOSPITAL CARDIAC-ARREST; HEART-ASSOCIATION GUIDELINES; TIME AUDIOVISUAL FEEDBACK; CHEST COMPRESSION RATES; INTRATHORACIC PRESSURE; CPR QUALITY; OUTCOMES; PERFORMANCE; SURVIVAL; DEPTH;

D O I：

10.1016/j.resuscitation.2015.04.031

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Aim of study: To evaluate CPR quality during cardiac resuscitation attempts in an urban emergency department (ED) and determine the influence of the combination of scenario-based training, real-time audiovisual feedback (RTAVF), and post-event debriefing on CPR quality. Methods: CPR quality was recorded using an R Series monitor-defibrillator (ZOLL Medical) during the treatment of adult cardiac arrest patients. Phase 1 (P1; 11/01/2010-11/15/2012) was an observation period of CPR quality. Phase 2 (P2; 11/15/2012-11/08/2013) was after a 60-min psychomotor skills CPR training and included RTAVF and post-event debriefing. Results: A total of 52 cardiac arrest patients were treated in P1 (median age 56 yrs, 63.5% male) and 49 in P2 (age 60 yrs, 83.7% male). Chest compression (CC) depth increased from 46.7 +/- 3.8 mm in P1 to 61.6 +/- 2.8 mm in P2 (p < 0.001), with the percentage of CC >= 51 mm increasing from 30.6% in P1 to 87.4% in P2 (p < 0.001). CC release velocity increased from 314 +/- 25 mm/s in P1 to 442 +/- 20 mm/s in P2 (p < 0.001). No significant differences were identified in CC fraction (84.3% P1 vs. 88.4% P2, p = 0.1), CC rate (125 +/- 3 cpm P1 vs. 125 +/- 3 cpm P2, p = 0.7), or pre-shock pause (9.7 s P1 vs. 5.9 s P2, p = 0.5), though CC fraction and pre-shock pause were within guideline recommendations. Conclusion: Implementation of the bundle of scenario-based training, real-time audiovisual CPR feedback, and post-event debriefing was associated with improved CPR quality and compliance with CPR guidelines in this urban teaching emergency department. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

引用

页码：8 / 13

页数：6

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