Abstract 14895: In-Situ Simulation Shows Challenges for 2-Minute Defibrillation Practice Standard
Background: Early defibrillation and quality compressions have been shown to improve survival after VT/VF arrest. Early chest compressions and defibrillation within 2 minutes of cardiac arrest improves 24-hour survival, but the best strategies are unclear for hospital implementation of early defibrillation programs. Recent studies suggest that the current 3-minute defibrillation recommendation may not be aggressive enough to produce results similar to those obtained in recent AHA CPR registry studies.
Design: A prospective pilot study was conducted in a teaching hospital to explore the feasibility of a 2-minute defibrillation standard for monitored units. The specific aims are to (1) describe current performance, and (2) identify best practices and barriers (staffing, equipment, systems) to successful strategies in managing VT/VF arrest.
Methods: 10 standardized in-situ VF scenarios were conducted using a Laerdal SimMan 3G® connected to hospital bedside monitors. To simulate ideal conditions, staff was told that a VF arrest would occur within 30 minutes and that the performance measures were the time to compression initiation and first defibrillation. In addition to real-time analysis, audio and video recordings were obtained and analyzed for performance verification, in addition to SimMan's built-in sensors.
Conclusions: Under simulated ideal circumstances, defibrillation within 2 minutes of monitored VF arrest is challenging in the hospital. In real world circumstances, feasibility of a 2 minute standard remains unclear. Although a 3-minute practice standard to first defibrillation is more attainable, the balance between formulation of standards and real world feasibility will need to be examined more fully.
- © 2011 by American Heart Association, Inc.