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

共 36 条

[11] Perishock Pause An Independent Predictor of Survival From Out-of-Hospital Shockable Cardiac Arrest [J].

Cheskes, Sheldon ;

Schmicker, Robert H. ;

Christenson, Jim ;

Salcido, David D. ;

Rea, Tom ;

Powell, Judy ;

Edelson, Dana P. ;

Sell, Rebecca ;

May, Susanne ;

Menegazzi, James J. ;

Van Ottingham, Lois ;

Olsufka, Michele ;

Pennington, Sarah ;

Simonini, Jacob ;

Berg, Robert A. ;

Stiell, Ian ;

Idris, Ahamed ;

Bigham, Blair ;

Morrison, Laurie .

CIRCULATION, 2011, 124 (01) :58-66

[12] Better adherence to the guidelines during cardiopulmonary resuscitation through the provision of audio-prompts [J].

Chiang, WC ;

Chen, WJ ;

Chen, SY ;

Ko, PCI ;

Lin, CH ;

Tsai, MS ;

Chang, WT ;

Chen, SC ;

Tsan, CY ;

Ma, MHM .

RESUSCITATION, 2005, 64 (03) :297-301

[13] Chest Compression Fraction Determines Survival in Patients With Out-of-Hospital Ventricular Fibrillation [J].

Christenson, Jim ;

Andrusiek, Douglas ;

Everson-Stewart, Siobhan ;

Kudenchuk, Peter ;

Hostler, David ;

Powell, Judy ;

Callaway, Clifton W. ;

Bishop, Dan ;

Vaillancourt, Christian ;

Davis, Dan ;

Aufderheide, Tom P. ;

Idris, Ahamed ;

Stouffer, John A. ;

Stiell, Ian ;

Berg, Robert .

CIRCULATION, 2009, 120 (13) :1241-1247

[14] Improving in-hospital cardiac arrest process and outcomes with performance debriefing [J].

Edelson, Dana P. ;

Litzinger, Barbara ;

Arora, Vineet ;

Walsh, Deborah ;

Kim, Salem ;

Lauderdale, Diane S. ;

Vanden Hoek, Terry L. ;

Becker, Lance B. ;

Abella, Benjamin S. .

ARCHIVES OF INTERNAL MEDICINE, 2008, 168 (10) :1063-1069

[15] Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest [J].

Edelson, Dana P. ;

Abella, Benjamin S. ;

Kramer-Johansen, Jo ;

Wik, Lars ;

Myklebust, Helge ;

Barry, Anne M. ;

Merchant, Raina M. ;

Vanden Hoek, Terry L. ;

Steen, Petter A. ;

Becker, Lance B. .

RESUSCITATION, 2006, 71 (02) :137-145

[16] The prevalence of chest compression leaning during in-hospital cardiopulmonary resuscitation [J].

Fried, David A. ;

Leary, Marion ;

Smith, Douglas A. ;

Sutton, Robert M. ;

Niles, Dana ;

Herzberg, Daniel L. ;

Becker, Lance B. ;

Abella, Benjamin S. .

RESUSCITATION, 2011, 82 (08) :1019-1024

[17] Sternal wall pressure comparable to leaning during CPR impacts intrathoracic pressure and haemodynamics in anaesthetized children during cardiac catheterization [J].

Glatz, Andrew C. ;

Nishisaki, Akira ;

Niles, Dana E. ;

Hanna, Brian D. ;

Eilevstjonn, Joar ;

Diaz, Laura K. ;

Gillespie, Matthew J. ;

Rome, Jonathan J. ;

Sutton, Robert M. ;

Berg, Robert A. ;

Nadkarni, Vinay M. .

RESUSCITATION, 2013, 84 (12) :1674-1679

[18]

Go AS, 2014, CIRCULATION, V129, pE28, DOI 10.1161/01.cir.0000441139.02102.80

[19] Relationship Between Chest Compression Rates and Outcomes From Cardiac Arrest [J].

Idris, Ahamed H. ;

Guffey, Danielle ;

Aufderheide, Tom P. ;

Brown, Siobhan ;

Morrison, Laurie J. ;

Nichols, Patrick ;

Powell, Judy ;

Daya, Mohamud ;

Bigham, Blair L. ;

Atkins, Dianne L. ;

Berg, Robert ;

Davis, Dan ;

Stiell, Ian ;

Sopko, George ;

Nichol, Graham .

CIRCULATION, 2012, 125 (24) :3004-3012

[20] Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: A prospective interventional study [J].

Kramer-Johansen, Jo ;

Myklebust, Helge ;

Wik, Lars ;

Fellows, Bob ;

Svensson, Leif ;

Sorebo, Hallstein ;

Steen, Petter Andreas .

RESUSCITATION, 2006, 71 (03) :283-292

← 1 2 3 4 →