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Start Over Topic cardiopulmonary resuscitation
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1. Cardiac resuscitation events: one eyewitness is not enough.

Author

Su L, Waller M, Kaplan S, Watson A, Jones M, and Wessel DL

Subjects
Adolescent, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac therapy, Beds, Child, Child, Preschool, Electrocardiography, Female, Heart Arrest complications, Heart Arrest epidemiology, Heart Arrest therapy, Humans, Infant, Male, Medical Records Systems, Computerized instrumentation, Observation methods, Oximetry, Paper, Video Recording methods, Vital Signs physiology, Cardiopulmonary Resuscitation, Heart Arrest diagnosis, Intensive Care Units, Pediatric, Medical Audit methods, Monitoring, Physiologic methods
Abstract

Objective: To determine the accuracy of paper cardiopulmonary resuscitation records., Design: Case series., Setting: Twenty-six-bed video-monitored pediatric cardiac ICU., Patients: All patients who had a resuscitation event with available video and electronically stored vital sign and waveform data from May 2012 to February 2013., Interventions: None., Measurements and Main Results: There were 41 cardiopulmonary resuscitation events during the study period. Fifteen had complete and valid data from the paper cardiopulmonary resuscitation forms, the retrieved monitor data, and the continuous bedside video monitoring. These 15 events occurred in 12 individual patients, and there was 100% agreement of data in the documentation of interventions in place (ventilation, arterial catheter, pulse oximetry, and vascular access) and in the presence of a witness at the onset of the arrest. All events were witnessed. Of the 15 events, video and monitor review revealed that 14 used waveform and numeric capnometry to confirm endotracheal tube/tracheostomy placement, but this section was only completed on the paper cardiopulmonary resuscitation record in three of the 14 cases. All records showed no discrepancies in the time of return of spontaneous circulation. The video and monitor review revealed delay in initiating cardiopulmonary resuscitation (mode, 2 min; two cases ≥ 7 min) and shockable rhythms (ventricular arrhythmia) in two cases. A sign of pulseless state was discovered in seven cases classified on the paper record as "always with a pulse." Those include sudden loss of consciousness, flat arterial line tracing, and abrupt drop in the partial pressure of exhaled carbon dioxide tracing (< 10 mm Hg)., Conclusions: Eyewitness accounts of cardiopulmonary resuscitation are often inaccurate and incomplete. Review of information from video and electronically stored vital sign and waveform data provides more accurate information than review of paper-based cardiopulmonary resuscitation records and may provide the insight necessary to improving cardiopulmonary resuscitation.

Published
2015
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2. Factors Influencing Performance of Cardiopulmonary Resuscitation (CPR) by Foundation Year 1 Hospital Doctors

Author

Sayee, Nicole and McCluskey, David

Subjects
Paper, Adult, Male, education, Internship and Residency, Northern Ireland, Manikins, Cardiopulmonary Resuscitation, Body Mass Index, Young Adult, Sex Factors, Humans, Female, Clinical Competence, Hospitals, Teaching
Abstract

Background Foundation Year One (FY1) doctors are often the first medical staff responders at in-hospital cardiac arrests. The study objectives were to assess the cardiopulmonary resuscitation (CPR) skills of FY1 doctors at a Belfast teaching hospital and to highlight factors that influence their performance. Methods A group of FY1 doctors working in a Belfast teaching hospital were asked to participate in this study. These junior doctors were regularly on-call for acute medical emergencies including cardiac arrest. Participants were instructed to perform two, 3 minute sessions of CPR on a skills reporter manikin. Each session was separated by a 5 minute rest period, one session using a compression-to-ventilation ratio of 15:2 and the other using a ratio of 30:2. Performance was gauged both objectively, by measuring the depth of chest compressions, and subjectively by a panel of 5 Advanced Life Support (ALS) instructors who reviewed the tracings of each CPR session. Results Overall, 85% of medical FY1's working in the hospital participated in the study. Objective results determined that males performed significantly better than their female counterparts using both the 15:2 and 30:2 ratios. The male FY1 doctors performed equally well using both 15:2 and 30:2 ratios, in comparison to female doctors who were noted to be better using the 15:2 ratio. Individuals with a Body mass index (BMI) greater than the mean for the group, performed significantly better than those with a lower BMI when using the 30:2 ratio. BMI was an important factor and correlated with chest compression depth. Females with a low BMI performed less well when using a ratio of 30:2. Overall, expert opinion significantly favoured the 15:2 ratio for the FY1 doctor group. Conclusion CPR performance can be influenced by factors such as gender and BMI, as such the individual rescuer should take these into account when determining which compression to ventilation ration to perform in order to maximise patient outcome. This study showed that males and those females with a BMI of >24 performed satisfactory CPR when using the recommended Resuscitation Council guidelines. Females with a BMI

Published
2012

3. Cardiac resuscitation events: one eyewitness is not enough

Author

Anne Watson, Mary J. Waller, Seth A. Kaplan, Melissa B. Jones, Lillian Su, and David L. Wessel

Subjects
Male, Paper, Resuscitation, Adolescent, Medical Records Systems, Computerized, Event (relativity), medicine.medical_treatment, Video Recording, Observation, Beds, Critical Care and Intensive Care Medicine, Intensive Care Units, Pediatric, Cardiac resuscitation, Electrocardiography, medicine, Humans, Cardiopulmonary resuscitation, Oximetry, Child, Monitoring, Physiologic, Medical Audit, business.industry, Vital Signs, Infant, Arrhythmias, Cardiac, medicine.disease, Cardiopulmonary Resuscitation, Heart Arrest, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Medical emergency, business
Abstract

To determine the accuracy of paper cardiopulmonary resuscitation records.Case series.Twenty-six-bed video-monitored pediatric cardiac ICU.All patients who had a resuscitation event with available video and electronically stored vital sign and waveform data from May 2012 to February 2013.None.There were 41 cardiopulmonary resuscitation events during the study period. Fifteen had complete and valid data from the paper cardiopulmonary resuscitation forms, the retrieved monitor data, and the continuous bedside video monitoring. These 15 events occurred in 12 individual patients, and there was 100% agreement of data in the documentation of interventions in place (ventilation, arterial catheter, pulse oximetry, and vascular access) and in the presence of a witness at the onset of the arrest. All events were witnessed. Of the 15 events, video and monitor review revealed that 14 used waveform and numeric capnometry to confirm endotracheal tube/tracheostomy placement, but this section was only completed on the paper cardiopulmonary resuscitation record in three of the 14 cases. All records showed no discrepancies in the time of return of spontaneous circulation. The video and monitor review revealed delay in initiating cardiopulmonary resuscitation (mode, 2 min; two cases ≥ 7 min) and shockable rhythms (ventricular arrhythmia) in two cases. A sign of pulseless state was discovered in seven cases classified on the paper record as "always with a pulse." Those include sudden loss of consciousness, flat arterial line tracing, and abrupt drop in the partial pressure of exhaled carbon dioxide tracing (10 mm Hg).Eyewitness accounts of cardiopulmonary resuscitation are often inaccurate and incomplete. Review of information from video and electronically stored vital sign and waveform data provides more accurate information than review of paper-based cardiopulmonary resuscitation records and may provide the insight necessary to improving cardiopulmonary resuscitation.

Published
2015