Abstract 87: Obstacles of Prompt Deployment of Mechanical CPR Devices During ED Resuscitation: a Video-Recording and Time-Motion Study
Background: Quality of CPR is important to survival. Mechanical CPR can provide constant CPR, especially during prolonged resuscitation, but the contribution of the device may be affected by deployment timeliness.
Objectives: To identify the timeliness of overall and essential steps of mechanical CPR devices deployment during actual emergency department (ED) resuscitation, defined as time to first constant mechanical compression; and to identify possible factors associated with mechanical CPR devices deployment performance
Methods: From July 2006 to December 2008, video clips from CPR sessions involving a mechanical device (Thumper, Michigan Instrument) in ED of National Taiwan University Hospital were retrieved and reviewed using time-motion analyses by experienced emergency physician. Timeliness of deployment, including the time from initial physician orders to first constant (sustained) mechanical compression (overall timeliness), and the time spent on each essential components of deployment were measured. Factors associated with performance were identified and categorized.
Results: From 2006 to 2008, a total 54 CPR recordings were available, and 18 mechanical CPR recordings were reviewed. On average, mechanical device took 178.4 seconds to deploy. The three most time-consuming steps were retrieving the machine after physician order (64.2 sec), getting the machine started once in position (45.0 sec), and placing the machine to the right position relative to patient (34.5sec). The most identifiable factors associated with deployment performance were availability of the machine, familiarity of device operation, and pre-defined position strategy.
Conclusions: Availability of the device and human factors such as familiarity of the machine and position strategy were associated with deployment performance of mechanical CPR device. Better deployment and education strategy would be needed to optimize the effect from mechanical CPR device during resuscitation.
- © 2010 by American Heart Association, Inc.