Hands-On Times, Adherence to Recommendations and Variance in Execution among Three Different CPR Algorithms: A Prospective Randomized Single-Blind Simulator-Based Trial.
- Rifai S Department of Orthopedics and Trauma Surgery, Bethesda Hospital, 47053 Duisburg, Germany.
- Sellmann T Department of Anaesthesiology and Intensive Care, Bethesda Hospital, 47053 Duisburg, Germany.
- Wetzchewald D Institution for Emergency Medicine, 59755 Arnsberg, Germany.
- Schwager H Institution for Emergency Medicine, 59755 Arnsberg, Germany.
- Tschan F Department of Psychology, University of Neuchatel, 2000 Neuchâtel, Switzerland.
- Russo SG Department of Anaesthesiology, University of Witten/Herdecke, 58448 Witten, Germany.
- Marsch S Department of Intensive Care, University Hospital, 4031 Basel, Switzerland.
- 2020-11-03
Published in:
- International journal of environmental research and public health. - 2020
adherence
cardiocerebral resuscitation
cardiopulmonary resuscitation (CPR)
guidelines
randomized trial
simulation
English
BACKGROUND
Alternative cardiopulmonary resuscitation (CPR) algorithms, introduced to improve outcomes after cardiac arrest, have so far not been compared in randomized trials with established CPR guidelines.
METHODS
286 physician teams were confronted with simulated cardiac arrests and randomly allocated to one of three versions of a CPR algorithm: (1) current International Liaison Committee on Resuscitation (ILCOR) guidelines ("ILCOR"), (2) the cardiocerebral resuscitation ("CCR") protocol (3 cycles of 200 uninterrupted chest compressions with no ventilation), or (3) a local interpretation of the current guidelines ("Arnsberg", immediate insertion of a supraglottic airway and cycles of 200 uninterrupted chest compressions). The primary endpoint was percentage of hands-on time.
RESULTS
Median percentage of hands-on time was 88 (interquartile range (IQR) 6) in "ILCOR" teams, 90 (IQR 5) in "CCR" teams (p = 0.001 vs. "ILCOR"), and 89 (IQR 4) in "Arnsberg" teams (p = 0.032 vs. "ILCOR"; p = 0.10 vs. "CCR"). "ILCOR" teams delivered fewer chest compressions and deviated more from allocated targets than "CCR" and "Arnsberg" teams. "CCR" teams demonstrated the least within-team and between-team variance.
CONCLUSIONS
Compared to current ILCOR guidelines, two alternative CPR algorithms advocating cycles of uninterrupted chest compressions resulted in very similar hands-on times, fewer deviations from targets, and less within-team and between-team variance in execution.
Alternative cardiopulmonary resuscitation (CPR) algorithms, introduced to improve outcomes after cardiac arrest, have so far not been compared in randomized trials with established CPR guidelines.
METHODS
286 physician teams were confronted with simulated cardiac arrests and randomly allocated to one of three versions of a CPR algorithm: (1) current International Liaison Committee on Resuscitation (ILCOR) guidelines ("ILCOR"), (2) the cardiocerebral resuscitation ("CCR") protocol (3 cycles of 200 uninterrupted chest compressions with no ventilation), or (3) a local interpretation of the current guidelines ("Arnsberg", immediate insertion of a supraglottic airway and cycles of 200 uninterrupted chest compressions). The primary endpoint was percentage of hands-on time.
RESULTS
Median percentage of hands-on time was 88 (interquartile range (IQR) 6) in "ILCOR" teams, 90 (IQR 5) in "CCR" teams (p = 0.001 vs. "ILCOR"), and 89 (IQR 4) in "Arnsberg" teams (p = 0.032 vs. "ILCOR"; p = 0.10 vs. "CCR"). "ILCOR" teams delivered fewer chest compressions and deviated more from allocated targets than "CCR" and "Arnsberg" teams. "CCR" teams demonstrated the least within-team and between-team variance.
CONCLUSIONS
Compared to current ILCOR guidelines, two alternative CPR algorithms advocating cycles of uninterrupted chest compressions resulted in very similar hands-on times, fewer deviations from targets, and less within-team and between-team variance in execution.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.3390/ijerph17217946
- PMID 33138109
- Persistent URL
- https://sonar.ch/global/documents/809
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