Comparison of Survival Rates Between Two Cardiopulmonary Resuscitation Protocols and the Association of Crew Consistency

Abstract

Background: Cardiac arrest is a life-altering event that requires swift, coordinated actions from numerous individuals for patient survival. Although return of spontaneous circulation is the goal of every emergency medical service agency, survival rates continue to be low due to many factors. Many variables are out of direct control of emergency medical service agencies, but some, such as protocol development and personnel training, are well within their power. Purpose: The purpose of this mixed-methods study was to examine the new HP-CPR protocol implemented by a large southeastern urban fire rescue department to see if changes to existing protocol assisted, in any way, with an increase in ROSC rates. The study also looked at group dynamics and whether crew consistency and well-defined positions played a role in patient survival. Operations personnel views and attitudes on the new protocol and importance of well-defined roles and consistency during a stressful event such as cardiac arrest were also investigated. Their input could shed light on other areas needing further research or improvement such as bystander intervention improvement strategies, response and on scene times, and location of arrest. Methods: This mixed-methods study evaluated the effectiveness of a protocol change in a large southeastern urban fire rescue department. It examined cardiac arrest incidents involving adults 18 years and older. The study compared survival rates between the previous protocol and the new high-performance cardiopulmonary resuscitation protocol, also known as pit crew cardiopulmonary resuscitation. It also examined whether crew consistency impacted survival rates and gathered crew perceptions of the new protocol and crew dynamics. Results: The results of the study provide evidence of effectiveness of the new protocol, areas for improvement, and whether group dynamics played a role in patient survival during out-of-hospital cardiac arrest. Conclusions: The results could guide future protocol development and provide a template for other agencies to follow that are experiencing low survival rates.