Abstract 165: Airway-Circulation-Leadership-Support (A-C-L-S) Team Training Model Improved Resuscitation Quality and Self-Perceived Team Efficacy Among Paramedics
INTRODUCTION The updated guidelines for advanced life support emphasize providers should coordinate and perform resuscitation in a team-based approach. A model called A-C-L-S was developed and our preliminary experience of this model applied in resuscitation team training for paramedics is described.
METHODS This was a prospective, before-and-after study. Forty-five paramedics, qualified ACLS providers, were grouped into nine teams. The team training course was delivered at the clinical skill center of National Taiwan University Hospital in October and November 2011.
The course consisted of: (1) a video-assisted lecture of A-C-L-S model, in which CPR technical and nontechnical tasks were prioritized and bundled into Airway, Circulation, Leadership, and Support; (2) two high-fidelity simulation-based cardiac arrest scenarios before and after the lecture, each followed by (3) video-facilitated debriefing.
During the two scenarios, time to first chest compression (Tc), first defibrillation (Td) and successful intubation (Ti) were measured. A 10-item, 5-point Likert scale questionnaire was administered to evaluate perception of CPR teamwork before and after the course.
RESULTS Among the pertinent resuscitation technical skills, there was significant improvement in Tc (90.9 vs. 52.6 seconds, p<0.05) after the A-C-L-S team training. Td and Ti decreased from 137.6 to 110.5 seconds (p=0.22) and 353 to 332.1 seconds (p=0.17) respectively. Perception of CPR teamwork improved significantly in seven items, including call out (3.62 to 4, p<0.05), check back (3.87 to 4, p<0.05), mutual support (3.47 to 4.02, p<0.05), effective communication (3.74 to 4.29, p<0.05), debrief (3.18 to 3.86, p<0.05), workload distribution (3.91 to 4.3, p<0.05) and shared goal (3.64 to 4.11, p<0.05) after the A-C-L-S team training.
CONCLUSIONS A team-based training model extending current ACLS paradigm is developed to facilitate learning and practice of technical and nontechnical skills during resuscitation. Application of the model in different scenarios and disciplines, and its impact on actual resuscitation performance and patient outcomes deserve further study.
- © 2012 by American Heart Association, Inc.