Abstract
IntroductionThe purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest.MethodsThis cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin.ResultsData from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ≥100 performed compressions at a significantly higher rate than participants identifying <100 (μ=117 vs. 94, p<0.001). Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p<0.01). No significant differences were found in depth or recoil performance based on knowledge of guidelines.ConclusionKnowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.
Highlights
The purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest
Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p
Poor quality CPR has been shown to have similar outcomes to patients receiving no CPR, whereas increased survival is associated with high quality CPR, the quality of chest compressions (CCs).[5,6]
Summary
The purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest. Cardiopulmonary arrest (CPA) is a major public health problem, and despite advances in cardiopulmonary resuscitation (CPR), survival and recovery remain suboptimal.[1] Early and effective CPR has been shown to improve survival after CPA.[2] both out-of-hospital and in-hospital providers often fail to provide high quality CPR.[3,4,5] Poor quality CPR has been shown to have similar outcomes to patients receiving no CPR, whereas increased survival is associated with high quality CPR, the quality of chest compressions (CCs).[5,6] recent recommendations have focused on CCs as the focus of compression optimization, which is reflected in the 2010 AHA Guidelines for CPR and ECC 7, as well as the ERC Guidelines for Resuscitation 2010 8 and 2010 CoSTR Guidelines.[9]. Specific components of CCs, including rate, depth, and recoil, have been found to affect outcome measures. Rates below published guidelines are associated with poor return of spontaneous circulation, which is concerning given that many providers deliver CCs at suboptimal rates.[4]
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