Journal article
Two minutes CPR versus five cycles CPR prior to reanalysis of the cardiac rhythm: A prospective, randomized simulator-based trial.
- Weichert V Department of Orthopedics and Trauma Surgery, Bethesda Hospital, Duisburg, Germany.
- Sellmann T Department of Anaesthesiology, Bethesda Hospital, Duisburg, Germany; Department of Anaesthesiology 1, Witten/Herdecke University, Witten, Germany.
- Wetzchewald D Institution for Emergency Medicine, Arnsberg, Germany.
- Gasch B Department of Psychology, Technical University of Dortmund, Dortmund, Germany.
- Hunziker S Department of Medical Intensive Care, University Hospital of Basel, Basel, Switzerland.
- Marsch S Department of Medical Intensive Care, University Hospital of Basel, Basel, Switzerland. Electronic address: stephan.marsch@usb.ch.
- 2015-08-04
Published in:
- Resuscitation. - 2015
Cardiopulmonary resuscitation
Guideline adherence
Randomized controlled trial
Simulation
Adult
Cardiopulmonary Resuscitation
Clinical Competence
Follow-Up Studies
Guideline Adherence
Heart Arrest
Humans
Manikins
Physicians
Prospective Studies
Simulation Training
Single-Blind Method
Time Factors
Video Recording
English
AIM OF THE STUDY
While the 2005 cardiopulmonary resuscitation (CPR) guidelines recommended to provide CPR for five cycles before the next cardiac rhythm check, the current 2010 guideline now recommend to provide CPR for 2 min. Our aim was to compare adherence to both targets in a simulator-based randomized trial.
METHODS
119 teams, consisting of three to four physicians each, were randomized to receive a graphical display of the simplified circular adult BLS algorithm with the instruction to perform CPR for either 2 min or five cycles 30:2. Subsequently teams had to treat a simulated unwitnessed cardiac arrest. Data analysis was performed using video-recordings obtained during simulations. The primary endpoint was adherence, defined as being within ±20% of the instructed target (i.e. 96-144s in the 2 min teams and 4-6 cycles in the fivex30:2 teams).
RESULTS
22/62 (35%) of the "two minutes" teams and 48/57 (84%) of the "five×30:2″ teams provided CPR within a range of ± 20% of their instructed target (P<0.0001). The median time of CPR prior to rhythm check was 91s and 87s, respectively, (P=0.59) with a significant larger variance (P=0.023) in the "two minutes" group.
CONCLUSIONS
This randomized simulator-based trial found better adherence and less variance to an instruction to continue CPR for five cycles before the next cardiac rhythm check compared to continuing CPR for 2 min. Avoiding temporal targets whenever possible in guidelines relating to stressful events appears advisable.
While the 2005 cardiopulmonary resuscitation (CPR) guidelines recommended to provide CPR for five cycles before the next cardiac rhythm check, the current 2010 guideline now recommend to provide CPR for 2 min. Our aim was to compare adherence to both targets in a simulator-based randomized trial.
METHODS
119 teams, consisting of three to four physicians each, were randomized to receive a graphical display of the simplified circular adult BLS algorithm with the instruction to perform CPR for either 2 min or five cycles 30:2. Subsequently teams had to treat a simulated unwitnessed cardiac arrest. Data analysis was performed using video-recordings obtained during simulations. The primary endpoint was adherence, defined as being within ±20% of the instructed target (i.e. 96-144s in the 2 min teams and 4-6 cycles in the fivex30:2 teams).
RESULTS
22/62 (35%) of the "two minutes" teams and 48/57 (84%) of the "five×30:2″ teams provided CPR within a range of ± 20% of their instructed target (P<0.0001). The median time of CPR prior to rhythm check was 91s and 87s, respectively, (P=0.59) with a significant larger variance (P=0.023) in the "two minutes" group.
CONCLUSIONS
This randomized simulator-based trial found better adherence and less variance to an instruction to continue CPR for five cycles before the next cardiac rhythm check compared to continuing CPR for 2 min. Avoiding temporal targets whenever possible in guidelines relating to stressful events appears advisable.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.resuscitation.2015.07.023
- PMID 26234894
- Persistent URL
- https://sonar.ch/global/documents/84085
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