Abstract 10412: Duration of Interruptions in Chest Compressions Increases with Increasing Number of Interventions During Cardiac Arrest

Abstract

Introduction: The American Heart Association recommends limiting chest compression interruptions to ≤10 seconds because prolonged interruptions are detrimental to survival in cardiac arrest. Determining the causes of interruptions is important to structure teams to minimize interruption time. This study sought to determine 1) whether performing more interventions during an interruption increases interruption time and 2) whether the time into the resuscitation in which the interruption occurs affects the duration of the interruption. Hypothesis: We hypothesize that the median duration of an interruption increases as the number of interventions increases and that the median duration of an interruption increases if it occurs later in the resuscitation. Methods: In January 2018 our Emergency Department (ED) began video recording all cardiac arrest resuscitations. These videos are reviewed by a committee of physicians, nurses, technicians, and research staff, and specific data points are confirmed by a physician. The duration of each interruption and cause of each intervention performed during each interruption was recorded. Results: A total of 122 patients with 798 chest compression interruptions from January 2018 to December 2020 were included in our analysis. Median age was 78 years and 44% were female. The median duration of interruptions was 13 seconds (interquartile range [IQR]: 10, 18) when no interventions were performed, 12 seconds (IQR: 8, 18) with 1 intervention, 17 seconds (IQR: 12, 26) with 2 interventions, and 19 seconds (IQR: 13, 24) with 3 or 4 interventions (p<0.0001). The median duration of interruptions was 14 seconds (IQR: 10, 22) in the first quartile of resuscitation length, 14 seconds (IQR: 10, 20) in quartile 2, 14 seconds (IQR: 10, 24) in quartile 3, and 11 seconds (IQR: 8, 18) in quartile 4 (p=0.0058). Conclusions: Our findings demonstrate that the median duration of chest compression interruptions increases as the number of interventions performed during that interruption increases. Additionally, interruption duration was shortest when the interruption was performed later in the resuscitation. These findings suggest that interruptions in chest compressions can be minimized by performing fewer tasks during the interruption.