Christopher Crowe1, Bentley J Bobrow2, Tyler F Vadeboncoeur3, Christian Dameff4, Uwe Stolz5, Annemarie Silver6, Jason Roosa7, Rianne Page8, Frank LoVecchio9, Daniel W Spaite10. 1. Maricopa Medical Center, Department of Emergency Medicine, 2601 East Roosevelt Street, Phoenix, AZ 85008, United States. Electronic address: ck55crowe@gmail.com. 2. Bureau of Emergency Medical Services and Trauma System, Arizona Department of Health Services, 150 N. 18th Ave., Suite 540, Phoenix, AZ 85007, United States; Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: Bentley.Bobrow@azdhs.gov. 3. Department of Emergency Medicine, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu. 4. Maricopa Medical Center, Department of Emergency Medicine, 2601 East Roosevelt Street, Phoenix, AZ 85008, United States. Electronic address: cdameffmd@gmail.com. 5. Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: Ustolz@aemrc.arizona.edu. 6. ZOLL Medical, 269 Mill Rd, Chelmsford, MA 01824, United States. Electronic address: Asilver@zoll.com. 7. Lutheran Medical Center, 8300 West 38th Avenue, Wheat Ridge, CO 80033, United States. Electronic address: jr_roosa@yahoo.com. 8. Maricopa Medical Center, Department of Emergency Medicine, 2601 East Roosevelt Street, Phoenix, AZ 85008, United States. Electronic address: riannepage@gmail.com. 9. Maricopa Medical Center, Department of Emergency Medicine, 2601 East Roosevelt Street, Phoenix, AZ 85008, United States. Electronic address: frank.lovecchio@bannerhealth.com. 10. Department of Emergency Medicine, University of Arizona, PO Box 245057, 1501 N. Campbell, Tucson, AZ 85724-5057, United States. Electronic address: Dan@aemrc.arizona.edu.
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 ± 3.8mm in P1 to 61.6 ± 2.8mm 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 (9.7s P1 vs. 5.9s 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.
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 arrestpatients. 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 arrestpatients 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 ± 3.8mm in P1 to 61.6 ± 2.8mm 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 (9.7s P1 vs. 5.9s 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.
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