Abstract 79: Impact of the 2010 Resuscitation Guidelines on CPR Quality During In-Hospital Cardiac Arrest
Background: The 2010 resuscitation guidelines emphasize quality compressions, including a target depth of “at least 2 inches” (50 mm), and a target rate of “at least 100 compressions/min”. Studies have demonstrated that the guidelines update has positively impacted CPR performance in the pre-hospital setting, but no such data exist for in-hospital CPR quality.
Hypothesis: We hypothesized that following the guidelines release, CPR data collected during in-hospital cardiac arrest events would demonstrate increased compression depth and rate, but that a lag period would exist prior to these observed changes.
Methods: Chest compression data from consecutive cardiac arrest events at a single medical center were collected prior to the guidelines change between 1/2010-9/2010 and compared to data collected after the guidelines release from 11/2010-2/2013, using a CPR-sensing defibrillator (MRx QCPR, Phillips Healthcare). Data were compared both in aggregate and in sequential 4 month time periods to evaluate for change over time. Welch’s t-test was used to compare compression rate and depth means across time periods.
Results: A total of 1,078 segments of CPR (30 sec each) performance were available for the pre-guidelines change period, and 1,652 30s segments for the post-guidelines release period. Mean compression rate and depth for the aggregate period following the guidelines release was increased (rate: 111.5 comp/min vs. 107.3 comp/min, p<0.001 and depth: 49.9 mm vs. 46.9 mm, p<0.001). Analysis for change over time found a consistent increase in rate after 4 months time and a lag-time of 16 months for a sustained increase in depth.
Conclusions: Following the 2010 release of updated CPR guidelines, compression rate and depth increased in a cohort of in-hospital resuscitation events. However, a lag time of 16 months for a sustained compression depth increase demonstrates the possibility of delayed uptake of new guidelines.
- © 2013 by American Heart Association, Inc.