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Evaluating the Quality of Cardiopulmonary Resuscitation in the Emergency Department by Real-Time Video Recording System.

ABSTRACT: To compare cardiopulmonary resuscitation (CPR) quality between manual CPR and miniaturized chest compressor (MCC) CPR. To improve CPR quality through evaluating the quality of our clinical work of resuscitation by real-time video recording system.The study was a retrospective observational study of adult patients who experienced CPR at the emergency department of Shanghai Tenth People's Hospital from March 2013 to August 2014. All the performance of CPR were checked back by the record of "digital real-time video recording system". Average chest compression rate, actual chest compression rate, the percentage of hands-off period, time lag from patient arrival to chest compression, time lag from patient arrival to manual ventilation, time lag from patient arrival to first IV establish were compared. Causes of chest compression hands-off time were also studied.112 cases of resuscitation attempts were obtained. Average chest compression rate was over 100 compression per minute (cpm) in the majority of cases. However, indicators such as percentage of hands-off periods, time lag from patient arrival to the first manual ventilation and time lag from patient arrival to the first IV establish seemed to be worse in the manual CPR group compared to MCC CPR group. The saving of operators change time seemed to counteract the time spent on MCC equipment. Indicators such as percentage of hands-off periods, time lag between patient arrival to the first chest compression, time lag between patient arrival to the first manual ventilation and time lag from patient arrival to the first IV establish may influence the survival.Our CPR quality remained to be improved. MCC may have a potentially positive role in CPR.

SUBMITTER: Chen S

PROVIDER: S-EPMC4592189 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Project description:ObjectiveTo investigate whether real-time audio and visual feedback during cardiopulmonary resuscitation outside hospital increases the proportion of subjects who achieved prehospital return of spontaneous circulation.DesignA cluster-randomised trial.Subjects1586 people having cardiac arrest outside hospital in whom resuscitation was attempted by emergency medical services (771 procedures without feedback, 815 with feedback).SettingEmergency medical services from three sites within the Resuscitation Outcomes Consortium in the United States and Canada.InterventionReal-time audio and visual feedback on cardiopulmonary resuscitation (CPR) provided by the monitor-defibrillator.Main outcome measurePrehospital return of spontaneous circulation after CPR.ResultsBaseline patient and emergency medical service characteristics did not differ between groups. Emergency medical services muted the audible feedback in 14% of cases during the period with feedback. Compared with CPR clusters lacking feedback, clusters assigned to feedback were associated with increased proportion of time in which chest compressions were provided (64% v 66%, cluster-adjusted difference 1.9 (95% CI 0.4 to 3.4)), increased compression depth (38 v 40 mm, adjusted difference 1.6 (0.5 to 2.7)), and decreased proportion of compressions with incomplete release (15% v 10%, adjusted difference -3.4 (-5.2 to -1.5)). However, frequency of prehospital return of spontaneous circulation did not differ according to feedback status (45% v 44%, adjusted difference 0.1% (-4.4% to 4.6%)), nor did the presence of a pulse at hospital arrival (32% v 32%, adjusted difference -0.8 (-4.9 to 3.4)), survival to discharge (12% v 11%, adjusted difference -1.5 (-3.9 to 0.9)), or awake at hospital discharge (10% v 10%, adjusted difference -0.2 (-2.5 to 2.1)).ConclusionsReal-time visual and audible feedback during CPR altered performance to more closely conform with guidelines. However, these changes in CPR performance were not associated with improvements in return of spontaneous circulation or other clinical outcomes. Trial Registration Clinical Trials NCT00539539.

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Evaluating the Quality of Cardiopulmonary Resuscitation in the Emergency Department by Real-Time Video Recording System.

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