Abstract
BackgroundCardiac arrest affects 30-35, 000 hospitalised patients in the UK every year. For these patients to be given the best chance of survival, high quality cardiopulmonary resuscitation (CPR) must be delivered, however the quality of CPR in real-life is often suboptimal. CPR feedback devices have been shown to improve CPR quality in the pre-hospital setting and post-event debriefing can improve adherence to guidelines and CPR quality. However, the evidence for use of these improvement methods in hospital remains unclear. The CPR quality improvement initiative is a prospective cohort study of the Q-CPR real-time feedback device combined with post-event debriefing in hospitalised adult patients who sustain a cardiac arrest.Methods/designThe primary objective of this trial is to assess whether a CPR quality improvement initiative will improve rate of return of sustained spontaneous circulation in in-hospital-cardiac-arrest patients. The study is set in one NHS trust operating three hospital sites. Secondary objectives will evaluate: any return of spontaneous circulation; survival to hospital discharge and patient cerebral performance category at discharge; quality of CPR variables and cardiac arrest team factors. Methods: All three sites will have an initial control phase before any improvements are implemented; site 1 will implement audiovisual feedback combined with post event debriefing, site 2 will implement audiovisual feedback only and site 3 will remain as a control site to measure any changes in outcome due to any other trust-wide changes in resuscitation practice. All adult patients sustaining a cardiac arrest and receiving resuscitation from the hospital cardiac arrest team will be included. Patients will be excluded if; they have a Do-not-attempt resuscitation order written and documented in their medical records, the cardiac arrest is not attended by a resuscitation team, the arrest occurs out-of-hospital or the patient has previously participated in this study. The trial will recruit a total of 912 patients from the three hospital sites.ConclusionThis trial will evaluate patient and process focussed outcomes following the implementation of a CPR quality improvement initiative using real-time audiovisual feedback and post event debriefing.Trial registrationISRCTN56583860
Highlights
Cardiac arrest affects 30-35, 000 hospitalised patients in the UK every year
This trial will evaluate patient and process focussed outcomes following the implementation of a cardiopulmonary resuscitation (CPR) quality improvement initiative using real-time audiovisual feedback and post event debriefing
The International Liaison Committee for Resuscitation (ILCOR) have developed evidence based guidelines for resuscitation which are used across NHS trusts [3]
Summary
Cardiac arrest affects 30-35, 000 hospitalised patients in the UK every year. For these patients to be given the best chance of survival, high quality cardiopulmonary resuscitation (CPR) must be delivered, the quality of CPR in real-life is often suboptimal. The CPR quality improvement initiative is a prospective cohort study of the Q-CPR real-time feedback device combined with post-event debriefing in hospitalised adult patients who sustain a cardiac arrest. The International Liaison Committee for Resuscitation (ILCOR) have developed evidence based guidelines for resuscitation which are used across NHS trusts [3] These can only improve outcomes if they are successfully implemented into clinical practice [4]. Chest compression depth [5,6]; rate [7]; ventilation rate [8] and duration of pre-shock pauses [6,9] have all been shown to influence the likelihood of a successful resuscitation attempt Despite these compelling data, observational studies during real life resuscitation attempts consistently demonstrate sub-optimal implementation of resuscitation guidelines in practice [10,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
