Abstract 12583: Low-Dose, High-Frequency Psychomotor CPR Skills Training Results in Improved and Sustained Performance of Optimal Adult/Child Ventilations in Fire-Based EMS Personnel

Abstract

Background: Hyper/over-ventilation (HOV) negatively effects cerebral blood and coronary artery flow during cardiac arrest. The resuscitation quality improvement (RQI) model of low-dose, high-frequency (LDHF) CPR training has been shown to improve CPR skills. Due to the deleterious impact of HOV on survival, our study seeks to determine if the RQI model improves ventilation skills for EMS personnel. We test the hypothesis that the RQI training results in improved and sustained ventilation performance. Methods: In 2014, our department transitioned from traditional BLS/ACLS training to the RQI model. Performance metrics are captured automatically for each rescuer on a quarterly basis using high-fidelity mannequins. Inclusion: All data from adult RQI attempts by EMS personnel from 2015-2019. Exclusion: attempts by non-EMS personnel. The 1 outcome measure is the overall mean (95% CI) ventilation score (composite measure, range 0-100, derived from average volume/rate and % with correct volume). The 2nd outcome measure is the proportion (95%CI) of rescuers with ventilation scores >90%. Data were extracted from RQI and analyzed with Prism statistical software. Comparisons for the 1 outcome was performed using one-way ANOVA and we report mean and 95% CI and proportions and 95% CI as appropriate. Results: During the study period, 740 personnel completed 1,490 ventilation activities in the baseline period and 5,077 in the subsequent years. The mean (95% CI) composite ventilation scores for the baseline was 84.10 (83.09,85.10) vs 2016 = 83.13 (82.17,84.09), 2017=88.79 (87.91,89.66), 2018=90.36 (89.45, 91.27), 2019= 88.59 (87.37, 89.81) for years 2016-2019; F= 41.36, R2=0.024, p value <0.0001. 10outcome: In the baseline RQI year, there were 55.3 % (95%CI= 52.8,57.8) participants with composite ventilation scores >/=90% vs. 2016= 53.5% (51.2,55.8), 2017=65.2%(62.6,68.6), 2018= 71.7%(69.1,74.3) and 2019=69.3%(66.1,72.2) in subsequent years. Limitations: Individual performance not reported, single agency. Conclusions: LDHF CPR training improves proper, and exceptional, ventilation performance in fire-based EMS personnel. Our results may be useful for other EMS agencies who are considering transitioning to LDHF training such as the RQI system.