Abstract 10092: Video Monitoring in a Cardiac Intensive Care Unit Provides Insight Necessary to Improving Cardiopulmonary Resuscitation
Background: Centers utilize a paper cardiopulmonary resuscitation (CPR) record to capture data for the Get With the Guidelines-Resuscitation (GWTG-R) database. The “recorder” is responsible for documenting the many simultaneous tasks that occur in the event.
Hypothesis: There is a difference between the data currently entered into the GWTG-R database and those data produced when video and monitor data are utilized.
Methods: Data from 18 events that occurred in a 26-bed video monitored pediatric cardiac intensive care unit between May 2012 and February 2013 were reviewed. Although there were a total of 41 arrests during this time period, the 18 events reviewed are a convenience sample based on the availability of monitor/video data. This study was determined to be IRB exempt. One faculty member and 1 nurse educator reviewed all available data after the arrest (video, monitor and CPR record) and generated the data for the GWTG-R database. These were compared to those data already entered based on the CPR record.
Results: Two of the 18 events were excluded because there was no paper CPR record suggesting that some arrests are not captured into the database. Two of the events involved the same patient and were excluded because of controversy over classification as 1 or 2 events. Of the remaining 14 events, the significant differences are shown in Graph 1. Most notable are events not captured by the CPR records such as the delay in CPR. At least 70% of the cases had a delay in CPR and 2 had delays greater than 7 minutes. Despite highly trained professionals witnessing the onset of cardiac arrest, and clinical evidence for the need for CPR (unconsciousness, flat arterial line or end tidal <10mmHg), most cases had a delay. Determining why is crucial. Two cases of ventricular arrhythmia were also never identified from traditional event review and 5 cases were misclassified as bradycardia with a pulse when no pulse was present. In conclusion, video data can provide insights critical to improving CPR.
- © 2013 by American Heart Association, Inc.