Measuring and improving cardiopulmonary resuscitation quality inside the emergency department

Christopher Crowe, Bentley J. Bobrow, Tyler F. Vadeboncoeur, Christian Dameff, Uwe Stolz, Annemarie Silver, Jason Roosa, Rianne Page, Frank LoVecchio, Daniel W. Spaite

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)8-13
Number of pages6
JournalResuscitation
Volume93
DOIs
StatePublished - Aug 1 2015

Keywords

  • CPR
  • CPR feedback
  • CPR quality
  • Cardiac arrest
  • Emergency medicine
  • Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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