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Resuscitation. 2015 Aug;93:8-13. doi: 10.1016/j.resuscitation.2015.04.031. Epub 2015 May 8.

Measuring and improving cardiopulmonary resuscitation quality inside the emergency department.

Author information

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.

KEYWORDS:

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

[Indexed for MEDLINE]

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