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Unnecessary interruptions of cardiac massage during simulated cardiac arrests

Published online by Cambridge University Press:  13 October 2005

S. C. U. Marsch ,
F. Tschan ,
N. Semmer ,
M. Spychiger ,
M. Breuer  and
P. R. Hunziker
S. C. U. Marsch
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
F. Tschan
Affiliation:
University of Neuchâtel, Department of Psychology, Neuchâtel, Switzerland
N. Semmer
Affiliation:
University of Bern, Department of Psychology, Bern, Switzerland
M. Spychiger
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
M. Breuer
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
P. R. Hunziker
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
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Extract

Summary

Background and objective: Cardiopulmonary resuscitation should not be interrupted until the return of spontaneous circulation or the decision to withhold further treatment. There are no data on how consistent in-hospital cardiopulmonary resuscitation is performed. Accordingly, the aim of the present study was to identify length and type of unnecessary interruptions in simulated cardiac arrests. Methods: The study was carried out in a patient simulator. A scenario of cardiac arrest due to ventricular fibrillation was used. Resuscitation teams consisted of three nurses, a resident and a staff physician. Using videotapes recorded during simulations, the activities of the teams were coded in 5-s intervals. Unnecessary interruptions were defined as any interruptions in cardiac massage of 10 s or more that were not caused by defibrillation or endotracheal intubation. Results: Twelve teams were studied. The total time of possible cardiac massage was 414 ± 125 s. In each team at least one unnecessary interruption occurred (range 1–5). Interruptions mounted up to 65 ± 40 s (range 20–155) or 16 ± 10% (range 5–41) of the total time of possible cardiac massage. Failure to swiftly resume cardiac massage after an unsuccessful defibrillation accounted for 14 of 39 episodes and for 44 ± 40% of the time of unnecessary interruptions. The debriefings revealed that participants had generally not noticed the unnecessary interruptions during the simulation. Conclusions: The present study identified a significant amount of unnecessary interruptions in cardiac massage. These interruptions were not noticed by the health-care workers involved.

Keywords

RESUSCITATIONCARDIOPULMONARY RESUSCITATIONHEART MASSAGEADVANCED LIFE SUPPORTTEACHINGPATIENT SIMULATION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 11 , November 2005 , pp. 831 - 833
Copyright
© 2005 European Society of Anaesthesiology

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References

Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation 2002; 105: 645–649.Google Scholar
Sato Y, Weil MH, Sun S et al. Adverse effects of interrupting precordial compression during cardiopulmonary resuscitation. Crit Care Med 1997; 25: 733–736.Google Scholar
Yu T, Weil MH, Tang W et al. Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation 2002; 106: 368–372.Google Scholar
van Alem AP, Sanou BT, Koster RW. Interruption of cardiopulmonary resuscitation with the use of the automated external defibrillator in out-of-hospital cardiac arrest. Ann Emerg Med 2003; 42: 449–457.Google Scholar
Peberdy MA, Kaye W, Ornato JP et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2003; 58: 297–308.Google Scholar
Cooper S, Wakelam A. Leadership of resuscitation teams: ‘Lighthouse Leadership’. Resuscitation 1999; 42: 27–45.Google Scholar
Mann CJ, Heyworth J. Comparison of cardiopulmonary resuscitation techniques using video camera recordings. Emerg Med J 1996; 13: 198–199.Google Scholar