Abstract 79: Improving the Quality of Cardiopulmonary Resuscitation by Training Dedicated Cardiac Arrest Teams in the Usage of a Mechanical Load-Distributing Device at the Emergency Department
Study Objective: To determine if implementing cardiac arrest teams trained with a sequence protocol in using a load distributing band mechanical CPR device (AutoPulse ZOLL), improves the quality of CPR, as determined by the No-Flow Ratio [NFR] in the 1st 10 minutes of resuscitation. The NFR is a function of compressions to pauses during the CPR cycle.
Methods: This is a phased, prospective, non-randomized, before-after cohort evaluation. Data collection was from April 2008 to February 2011. There were 100-before and 107-after cases. Continuous video and chest compression data with the Physiocontrol Codestat Suite 7.0, of all study subjects were analyzed. All non-traumatic, collapsed patients older than 18 years old, presenting to the Emergency Department were eligible.
Results: After implementation, the mean total NFR for the 1st 5 minutes and the next 5 minutes respectively decreased from 0.42 to 0.27 (difference = 0.15, 95%CI 0.10 to 0.19, p<0.005), and from 0.24 to 0.18 (difference = 0.06, 95%CI 0.01 to 0.11, p=0.01). The mean time taken to apply AutoPulse (seconds) decreased from 208.8s to 144.5s (difference = 64.3, 95%C.I, 18.0 to 110.6, p=0.007). Overall, the mean CPR ratio, which is the percentage of time with active CPR in a resuscitation, increased from 46.4% to 88.6% (difference = 42.2%, 95%CI 37.1% to 47.2%, p<0.005) and the mean total NFR for the 1st 10 minutes decreased from 0.33 to 0.23 (difference = 0.10, 95%CI 0.07 to 0.14, p<0.005).
Conclusion: Implementation of cardiac arrest teams was associated with a reduction in no-flow ratio in the 1st 10 minutes of resuscitation. We recommend that training cardiac arrest teams in a specially sequenced protocol can improve the quality of CPR at the ED.
- © 2011 by American Heart Association, Inc.