Abstract 15955: Impact of an Automated Chest Compression Device on Team Communication During Simulated Cardiac Arrest Resuscitations - A Pilot Study

Abstract

Background: Communication and teamwork failures correlate with diagnostic errors and deviations from ACLS protocols during cardiac arrest (CA) resuscitation. High task workloads stress teams’ capacity and negatively impact team effectiveness. The LUCAS ® Chest Compression System (Physio-Control, Redmond, WA) is an automated chest compression device intended to reduce workload associated with chest compression delivery. Objective: To assess the impact of LUCAS on team communication and adherence to ACLS algorithms during a simulated CA resuscitation. Methods: Resuscitation teams (n=12) were randomly assigned to manual compressions (control) or LUCAS (intervention) during a simulated CA consisting of Phase 1, pre-arrest (Baseline), and Phase 2, ventricular fibrillation phase (Arrest). Phase 1 metrics included total team communication statements and 10 patient care actions. Phase 2 communication was measured as number of statements related to (a) CPR coordination, (b) compression performance, and (c) diagnosis. Phase 2 patient care metrics included (a) adherence to ACLS algorithm and (b) quality of compressions. Statistical analyses included descriptive statistics, paired t-test, and effect size (Hedge’s g). Results: In Phase 1 there was no difference in either communication or patient care outcomes. In Phase 2, teams in the intervention group (n=6) made more frequent statements focused on diagnosis (Hedge’s g = 1.88, t[df 10]=3.53, p=0.01) and fewer directed toward CPR coordination (Hedge’s g = -0.98, t[df 10] = -1.85, p = 0.1) and compression performance (Hedge’s g = -1.55, t[df 10]=-2.91, p = 0.02). Teams using the LUCAS had a 22.8% decrease (95% CI [-48.80, 3.24]) in delivery of poor quality chest compressions (Hedge’s g = 1.04, t[df 10] = -1.87, p=0.08) and fewer deviations in medication administration (Hedge’s g = -1.49, t[df 10] = -1.87, p=0.02) as compared to in the control group (n=6). Conclusions: In this small pilot study, use of an automated compression device was associated with an increase in team communication focused on diagnosis and improved adherence to ACLS algorithms. While not all outcomes reached statistical significance, the large effect sizes demonstrate practical significance. A larger study may reach statistical significance.