This review outlines the foundational requirements for safely managing medical emergencies during interventional pain procedures. It emphasizes staff preparedness, continuous patient monitoring, emergency response planning, transfer protocols, and the availability of essential crash cart equipment, medications, and airway supplies. The review highlights the importance of regular training, Basic Life Support/Advanced Cardiovascular Life Support competency, and systematic risk mitigation to optimize patient outcomes during unforeseen emergencies.

Aim of the StudyResuscitation carts are essential for ensuring rapid access to life-saving medications during cardiopulmonary resuscitation (CPR). However, limited guidance exists on which medications to include. This study aims to determine the essential medications for inclusion in a resuscitation cart, based on the utilization and evidence-based recommendations.MethodsThis is a retrospective study for adult cancer patients who underwent CPR between March 2023 and March 2024. Medications utilized during CPR were collected from electronic medical records. Based on clinical guidelines and utilization rates, medications were categorized into three groups: Group A, medications utilized during CPR and/or with strong evidence to include, and kept with no change, Group B, essential medications but requiring quantity modifications, and (C) non-essential medications or not utilized during CPR and were removed. Pharmacy working hours needed for carts maintenance processes were evaluated before and after the change.ResultsA total of 881 CPRs were performed during the study period. Among the 25 medications included in the carts, 11 were classified in group A, 2 in group B, and 12 in group C. Based on the available data, the total number of medications in the resuscitation carts was reduced to 13 medications. This reduced cart maintenance time from 602 to 241 h annually.ConclusionOptimizing resuscitation cart medications using evidence and utilization data can effectively reduce the number of medications, time required for cart management, and medication waste. Future research may explore other patient populations, to support the development of universal guidance on resuscitation cart medication content.

There is limited understanding of why some individuals choose to end their lives in road traffic. This study aimed to explore the underlying reasons for such decisions by analyzing information on suicide attempts collected by Finnish multidisciplinary road crash investigation teams. The sample comprised 56 incidents over a ten-year period (2013−2022), nearly all involving deliberate motor vehicle crashes. Our analysis drew on both computerized data and original investigation reports. Reasons for choosing road suicide were identified in 16 of the 56 cases (29%). The most commonly cited motivations included perceptions of the method as lethal, easy, simple, and quick, as well as associations with impulsivity. Given the inherent challenges in accurately identifying suicidal intent in traffic crashes, it appears that investigation teams may primarily focus on distinguishing suicides and suicide attempts from unintentional accidents. In our assessment, the teams generally provided sufficient evidence to support their conclusions regarding the intentional nature of the crashes. However, we argue that whenever a suicide attempt is suspected on the road network, efforts should also be made to understand the factors influencing the choice of this method. Such insights are essential from both traffic safety and suicide prevention perspectives. • There is limited understanding of why some individuals choose to end their lives in road traffic. • We analyzed 56 attempted road suicides investigated by multidisciplinary teams. • Reasons for choosing road suicide were identified in 16 of the 56 cases (29%). • The method was seen as lethal, easy, simple, and quick.

Radio frequency identification (RFID) technology has been proposed to be the barcode of the future, with new technology forms such as Bluetooth low energy (BLE) integrated into real-time location systems (RTLS). In health systems, RTLS have evolved to track medical equipment and other assets via BLE beacons that transmit data via serial numbers to a gateway, which relays information to a software system to display current location. This case study explored how BLE beacon data and RTLS can be leveraged to enhance interdisciplinary workflows and streamline crash cart management. Houston Methodist implemented a BLE-based tracking system for 349 crash carts across 8 hospitals. Pharmacy and central supply teams collaborated to develop a standardized workflow for maintaining crash carts. Integration with an existing inventory management system enabled real-time visibility of cart locations and expiration tracking of medications and supplies. The new workflow for crash cart management streamlined operations, decreased staff workload, and increased patient safety. Implementation challenges included vendor transitions, gateway visibility, and staff training, which were addressed through interdisciplinary coordination and technological enhancements. The visibility of crash carts improved from 0% to over 90% at most sites, and labor savings at the flagship hospital were estimated at $8,500 annually. BLE-enabled RTLS significantly improved crash cart visibility, streamlined labor hours, and enhanced operational efficiency. This case study supports national recommendations for integrating RFID technologies into medication-use systems and highlights the importance of interoperability, stakeholder engagement, and workflow standardization. The findings may inform broader adoption of RTLS in health systems seeking to enhance safety and streamline operations.

Latent safety threats (LSTs) in operating room (OR) crisis management contribute to serious events such as Local Anesthetic Systemic Toxicity (LAST) and represent critical yet often overlooked risks. Although prior research has focused on clinician education for diagnosing and treating LAST, far less attention has been directed toward work-system factors (eg, workflow design, communication processes, environmental supports), even though education alone is insufficient. This study advances understanding of OR crises by systematically identifying and characterizing LSTs across all phases of LAST response, from briefing and diagnosis to treatment and care planning, capturing the broader system factors that influence team performance and patient safety. Thirty-eight staff (15 anesthesiologists, 16 nurses, 7 anesthesia assistants) participated in 8 simulations. Video recordings were analyzed to identify LSTs, which were inductively coded into themes/subthemes, categorized by clinical phase (briefing, diagnosis, management, treatment, care planning) and by system factor using a modified SEIPS framework (organization, environment, tasks, tools, teams, individuals). We identified 183 LSTs, with frequency varying by clinical phase (P < .001); nearly half (90/183; 49%) occurred during Management after diagnosis. LSTs spanned all SEIPS factors, most often Environment (55/183; 30.1%), Organization (54/183; 29.5%), and Tasks (38/183; 21.3%). The most common themes were Poor Physical Layout (43/183; 23.5%) and Role Allocation Deficiencies (42/183; 23%), both directly impairing performance (eg, delays retrieving the crash cart or administering intralipid). Additional LSTs included communication breakdowns, task overload, ambiguous dosing, tool usability issues, and unclear protocols. Knowledge gaps were least common and had minimal clinical impact. The findings highlight that improving LAST crisis response requires more than clinician education. Many LSTs arise from how clinical environments are structured, how teams communicate, and how workflows unfold under pressure. To strengthen LAST crisis response and other emergency interventions, systems must be redesigned to reflect the realities of team-based care and to support clinical workflows across all phases of the response.

Abstract Background: Crash cart competency is a critical, high-stakes skill for nursing staff, directly impacting resuscitation outcomes. This study evaluates the effectiveness of a structured simulation-based training program during nursing induction by analyzing pre- and post-test knowledge scores. Methods: A pre-post intervention study was conducted with 19 new nursing staff. A 10-point knowledge test on crash cart protocols, medication, and equipment was administered before and after a standardized high-fidelity simulation training session. Scores were categorized into three competency levels: Adequate Knowledge (&gt;70%), Needs Improvement (31-69%), and Inadequate Knowledge (&lt;30%). Results: Pre-test analysis revealed significant baseline knowledge deficits: only 6 staff (31%) demonstrated adequate knowledge, while 7 (36%) scored in the inadequate range. Post-training results showed dramatic improvement: 14 staff (74%) achieved adequate knowledge, and no staff remained in the inadequate range. The proportion of staff with adequate knowledge increased by 43 percentage points. The mean test score improved from 4.3 (SD=2.5) to 8.1 (SD=1.85), representing a statistically significant increase (p&lt;0.001). Conclusion: Simulation-based training is highly effective in rapidly improving crash cart knowledge among new nursing staff, effectively moving the majority from inadequate to adequate competency levels. However, the persistence of a subgroup (26%) requiring improvement highlights the need for targeted remediation and ongoing assessment. This training model should be integral to nursing induction programs to ensure emergency preparedness.

IntroductionEssential medications, supplies, and equipment are crucial for emergency care; however, significant resource shortages in low- and middle-income countries, including Ethiopia, hinder the delivery of safe services. Although research on emergency capacity analysis has been conducted at the hospital level, data from lower levels, such as health centers, are lacking, despite numerous studies recommending the development of emergency services at the primary healthcare level to reduce the burden on hospital emergency departments. Therefore, this study primarily aims to assess the availability of emergency equipment and drugs and barriers to availability in health centers in Addis Ababa, Ethiopia.MethodsAn explanatory sequential mixed method design study was conducted in Addis Ababa, in September 2025. Quantitative data were collected from the six health centers selected through convenience and random sampling. Non-probability purposive sampling was used to select key informants for the qualitative interviews, and thematic content analysis was conducted to develop items that emerged from the transcribed information.ResultsThe survey revealed a significant gap in availability of emergency equipment and drugs. While oxygen delivery devices and infection control materials were widely available, critical equipment and essential medications like crash carts, defibrillators, digoxin, and sodium bicarbonate were largely absent. Qualitative analysis identified the barriers to be ineffective management, disjointed logistics and health system, shortage of human resource and patients’ financial constraint.DiscussionThe readiness of health centers to provide emergency care in Addis Ababa is inadequate, largely due to resource shortages and systemic barriers. Urgent interventions are needed to improve emergency preparedness at the primary care level, including provision of crash carts, investment in staff training, and revision of procurement and policy frameworks.

This review aims to provide an evidence-based guide to reducing burnout in emergency rooms and other critical care settings. Some experts suggest that organizational risk factors such as work overload and role ambiguity are causes, while others believe that an imbalance between professional demands and available resources contributes to burnout. In healthcare, increased patient care demands, limited resources, and chaotic work environments can worsen these issues. In simple terms, high work stress without proper management may cause healthcare workers to become patients themselves. This work explores evidence-based leadership strategies, organizational interventions, and policy recommendations designed to help healthcare leaders combat burnout among their teams. By emphasizing ethical leadership, altruism, and motivation, the goal is to offer strategies that enable healthcare managers to lead their teams through the challenges of emergency care and foster psychological resilience to better serve their patients.

Background: High-quality cardiopulmonary resuscitation (CPR) is critical for survival after pediatric cardiac arrest, yet adherence to guideline metrics and timely utilization of equipment remain inconsistent. CPR coaches have been described to improve CPR quality; however, a standardized training approach has not been defined. We sought to develop and implement a streamlined CPR coach training program using multimedia education and rapid cycle deliberate practice simulations to enhance adherence to resuscitation guidelines and CPR quality. Concurrently, a dedicated bedside CPR Cart was introduced to improve resuscitation ergonomics and efficiency. Objectives: To evaluate the impact of CPR coach training on provider knowledge and perceptions of pediatric resuscitation efficiency using the CPR Cart compared to a traditional pediatric crash cart. Methods: A cross-sectional survey was distributed to frontline physicians, advanced practice providers, nurses, and respiratory therapists at a large, tertiary pediatric hospital. The survey assessed demographics, CPR knowledge, and perceptions of the CPR coach and CPR Cart. Respondents were categorized as CPR coach-trained or non-trained. Mann-Whitney U and McNemar tests were applied where appropriate to compare knowledge scores, preparedness as the role of CPR coach, and perceptions of the CPR Cart versus a traditional pediatric crash cart. Results: Among 226 responses, 56 (25%) had participated in dedicated CPR coach training. CPR coach-trained individuals scored higher on knowledge of key CPR principles compared to non-trained individuals (median 93% vs 64%, p &lt; 0.001). Trained staff reported higher preparedness (range 0-100) to assume the role of CPR coach than those who had not been trained (median 87 vs 25, p &lt;0.001). Among those who had experience with both the CPR Cart and the traditional pediatric crash cart (n = 119), the CPR Cart was preferred over the traditional pediatric crash cart (p &lt; 0.001), with respondents rating it higher for rapid equipment access, positioning, and workflow efficiency during CPR (Figure 1). Conclusions: A structured CPR Coach training program improves provider CPR knowledge and enhances perceptions of resuscitation effectiveness. The streamlined bedside CPR Cart further optimizes the reported efficiency of pediatric resuscitations. Future research should explore the longitudinal impact of these interventions on real-time clinical performance and survival outcomes.

Historically nurses have been drivers of innovation, from Florence Nightingale’s sanitation movement in the 1850’s to Anita Dorr creation of the code cart. This article explores the ingenuity of nursing and emphasizes the importance of education and professional development of bedside nurses. Amid the demands of increasing patient acuity and healthcare challenges, equipping bedside nurses with specialized education can yield improved patient outcomes alongside bedside nurse retention. The pioneering Nursing Research Fellowship in Robotics and Innovation at a local Delaware hospital is leading the way for nurses to engage in research, acquire new skills and become voices of change on their units. This fellowship demonstrates how a structured investment in nurses fosters curiosity and innovation, by offering nurses the tools, time, and support to ask “why not” and unlock solutions to today’s healthcare challenges.

Upper gastrointestinal (GI) bleeding leads to approximately 350,000 hospital admissions annually. Simulation-based training enhances medical education by improving quality care, patient safety, and clinical competency. To increase internal medicine (IM) residents' exposure to critical GI concepts, we developed a GI bleed simulation curriculum. A total of 129 IM residents participated in a hands-on simulation using a high-fidelity manikin. Pre- and postsimulation surveys assessed demographics, confidence, and knowledge. The case involved a 45-year-old male with alcohol use disorder, hematemesis, and hemodynamic instability. Key learning outcomes included assessing vitals, performing a physical exam, initiating resuscitation, ordering appropriate medication, consulting GI, and creating a differential. Critical equipment included a code cart and moulage blood. A postsimulation debrief addressed the management of esophageal varices (EV), peptic ulcer disease (PUD), central venous access, massive transfusion protocol, and hemorrhagic shock. Confidence improved for PGY 1 and PGY 2 residents in all categories (p < .05). PGY 3 residents increased their confidence managing EV (p = .03), PUD (p = .002), and outpatient EV (p = .003). PGY 1 and PGY 2 knowledge increased with treatment of nonvariceal GI bleeds (p < .001, p = .001). All residents increased in their knowledge of timing of endoscopy for EV bleeds (p < .001). Among all residents combined, there was an increase in knowledge of discharge medications for EV and PUD (p = .01). A hands-on simulation curriculum positively impacted IM residents' confidence and knowledge in managing GI bleeds, highlighting its educational value.

ABSTRACT Simulation training aims to increase exposure to high-stakes low-frequency events like cardiac arrest. However, within our laboratory-based simulation program, we have observed limited buy-in from internal medicine (IM) residents due to competing patient care obligations and a limited fidelity environment. Mirroring patient data within in situ simulation may provide relevance to ongoing resident patient care obligations, increasing buy-in and confidence in management. Clinical data from presently admitted patients in our institution’s medical intensive care unit (MICU) was ‘mirrored’ to create cardiac arrest simulations. Simulations took place in a vacant MICU patient room with resuscitation equipment, including a code cart, saline-substituted medications, and a mannequin capable of endotracheal intubation. The trainee team consisted of one post-graduate year (PGY) 3 IM resident, two PGY-1 residents, and a critical care fellow. A pre- and post-survey was administered to the PGY-3 IM resident to assess confidence in performing technical and non-technical skills. An advanced cardiac life support (ACLS) instructor evaluated PGY-3 IM resident performance using a skills checklist. Eighty-three percent of PGY 3 residents endorsed changes to their practice following the simulation. Confidence increased in skills related to flexible decision-making skills but not for fixed skills such as following ACLS protocol. Qualitative feedback highlighted realism, spontaneity, and debriefing sessions as the most valuable aspects of the program. In situ mirror simulation may be a useful adjunct for IM residency programs suffering similar concerns with learner motivation during laboratory simulation.

This study assesses the effectiveness of a self-instructional module on improving knowledge regarding the utilization of emergency crash carts in hospitals among B.Sc. Nursing 2nd year students in selected nursing colleges in Jabalpur. Using a quasi-experimental pre-test post-test design, 60 students participated in the study. The results demonstrated a significant improvement in the students’ knowledge post-intervention, with a mean score increase from 13.6 in the pre-test to 18.61 in the post-test (t=41.75, p<0.05). The study also revealed significant associations between demographic variables such as age, gender, prior knowledge, and attendance at workshops with knowledge scores. The findings highlight the critical role of structured educational interventions in enhancing nursing students' competency in emergency care, ultimately improving hospital emergency preparedness.

BackgroundMost medical responders are not adequately trained to recognize and treat maternal medical emergencies, including maternal cardiac arrest, and national credentialing standards do not exist. Obstetric Life Support (OBLS) is a validated simulation-based curriculum designed to equip prehospital and hospital-based healthcare workers (HCWs) with the knowledge and skills necessary to prevent, recognize, and manage maternal medical emergencies. Widespread implementation of OBLS could enhance patient safety and reduce disparities in maternal morbidity and mortality. However, research is needed to develop strategies that ensure sustained and equitable access for HCWs across diverse healthcare settings. This paper presents a protocol for evaluating a train-the-trainer approach to implement OBLS in hospitals, freestanding birthing centers, and prehospital contexts across Arizona.MethodsThis multisite, mixed-methods study is being conducted in collaboration with the Arizona Perinatal Trust, a regional perinatal health system that encompasses 38 in-hospital birthing centers and Level I-IV hospitals across Arizona, and the Arizona Emergency Medical Systems LLC, which coordinates 85 emergency medical services agencies statewide. A Steering Committee comprising local, regional, and national stakeholders provides guidance and oversight for all study activities. To promote rapid learning, two consecutive OBLS implementation and evaluation cycles will be conducted, with the second cycle incorporating feedback and lessons learned from the first. HCWs from 16 implementation sites (8 per cycle) serving areas with high maternal vulnerability indexes will be trained as OBLS instructors. These instructors will train at least 160 HCWs (80 per cycle) within their respective or nearby institutions. Outcomes to be assessed include reach (proportion and representation of institutions offering OBLS, instructors trained, and HCWs participating), effectiveness (impact of OBLS on knowledge and clinical competencies, presence of code carts containing OBLS cognitive aids and resuscitative cesarean delivery kits in hospitals, and the use of an OB Arrest Alert in prehospital settings), adoption (allocation of resources for OBLS), implementation (number of courses completed, fidelity of the training delivery), and maintenance (extent to which training becomes integrated into routine practice and policy).DiscussionFindings from this statewide study will be used to promote the scale-up and sustainability of OBLS, ultimately enhancing maternal healthcare quality and equity.

This Quality Improvement Project (QIP) aimed to improve the response system for crash calls at Park House Mental Health Hospital, supported by the North Manchester General Hospital Crash Team. Using a functional resonance analysis method (FRAM), the team identified inefficiencies in the Advanced Life Support (ALS) process, with delayed responses increasing patient mortality risks. Interviews with staff helped create "work-as-imagined" (WAI) and "work-as-done" (WAD) models, highlighting the underperformed functions like ward entry protocols, and fully stocked crash trolleys. Recommendations, including access cards, stock changes, and live simulations, were implemented, in an aim to improveALS provision.

IntroductionWhen patients are critically ill, our hospital practice has been to have pharmacy mix the vasopressor medication infusion bags. The provider enters the order, pharmacy prepares the medication, then the nurse hangs and programs the medication into the pump for delivery to the patient. Nurses must be diligent to reorder the medication in a timely manner to ensure these vasopressor infusion bags do not run empty. Many Intensive Care Unit (ICU) nurses are comfortable mixing Norepinephrine infusion bags when needed due to the critical needs of patients on their units. However, many ICU nurses are not comfortable mixing Epinephrine medication infusions when needed. This lack of comfort and knowledge along with the delivery process led to an unfortunate outcome in this case scenario review.MethodsCase Study: A 69-year-old patient was admitted to the hospital for lower leg and back pain, cellulitis, red macules, bruising and possible Stevens Johnson Syndrome. An Epinephrine infusion was ordered and hung at 1004. The Epinephrine infusion was started at a rate of 206.4 mL/HR (0.8 mcg/kg/min) from a 250 mL bag. The infusion was titrated up several times over the next 50 minutes with a final infusion rate of 258 mL/HR (1 mcg/kg/min). At 1108 the Epinephrine replacement bag was reordered from pharmacy. The Epinephrine infusion ultimately ran empty at 1118 prior to the next bag being delivered to the unit. The patient’s bradycardia worsened, leading to a Pulseless Electrical Activity (PEA) cardiac arrest. CPR was initiated and the code was managed by the code team. Ultimately CPR was stopped at the request of the family.ResultsPre-mixed Epinephrine infusion bags added to all adult ICU Omnicells. Pre-mixed Vasopressin infusion bottles added to all adult ICU Omnicells. Pre-mixed Norepinephrine infusion bags added to all Crash Carts throughout the hospital (pre-mixed norepinephrine infusion bags were already available in the ICU Omnicells). How To Mix signage was added to all Adult ICU area medication rooms or near the Omnicells.ConclusionsDue to the unfamiliarity in mixing an epinephrine infusion bag on the unit, the medication ran empty prior to the delivery of a replacement bag. This led to a hospital review and implementation of pre-mixed epinephrine being added to the Burn ICU Omnicell and other adult ICU Omnicell’s throughout the hospital. All together several improvements were made after reviewing this incident.Applicability of Research to PracticeThis event led to a hospital change in the availability of pre-mixed vasopressors for the adult ICUs. More research could be done to compare the outcomes of critically ill patients on vasopressors mixed within the facility versus pre-mixed vasopressors. Additional research could be done comparing the number of adverse medication events with critically ill patients on vasopressors mixed within the facility versus pre-mixed vasopressors.Funding for the StudyN/A

The importance of a well-equipped and efficiently organised code cart cannot be overstated in the context of providing optimised emergency care for children. In addition to quality improvement initiatives addressing appropriate maintenance of code cart supplies, there is the global need to focus on efficient and intuitive paediatric code cart design to manage this unique population separately from adults.

Background and Aims: This study aims to decrease the knowledge gab in literature by investigating physician’s understanding of the crash cart medications, their perception of it, and how they utilize it. Methods: This is a cross-sectional study targeting primary care physicians across Saudi Arabia. Stratified sampling was used in which general and family physicians were distributed over five regional strata. The sample size was determined to be 366 physicians. The data distribution was tested individually for each subset using the Anderson-Darling test and hence determining the appropriate statistical test accordingly. T-test and one-way ANOVA were used for parametric statistical tests, Mann-Whitney and Kruskal-Wallis were used for non-parametric tests, and finally Wald test was utilized in binary logistic regression analysis. Minitab statistical package [version 19.2020.1(64-bit)] was used to perform all statistical analysis in this research. Results: 324 responses across Saudi were collected, with 7.04/10 as a mean knowledge score. The mean knowledge score considered high with 1.92 standard deviation. Non- Saudi physicians had significantly higher knowledge than Saudi physicians did. Physicians who reported being able to interpret electrocardiogram rhythms had significantly higher knowledge scores compared to those who could not. Easiness of performing cardiac compressions was also linked to better knowledge scores compared to those with some difficulties. Conclusion: Addressing the identified barriers and implementing standardized crash cart protocols in PHCs can significantly improve emergency preparedness and patient outcomes. Investing in the ongoing development of physicians’ emergency management skills will ultimately enhance the overall quality of care in PHC settings.

Iodinated contrast media allergy is considered as a strong contra-indication for performing sialography. There is little evidence to support this approach. To evaluate the rate of iodinated contrast media (ICM) allergy in subjects undergoing sialography and to assess the risk for allergic responses in patients with a previous diagnosis of allergy. We retrospectively reviewed sialo-CBCT studies performed from 2014 to 2019. During the study period we implemented a protocol for performing sialo-CBCT in patients with a prior diagnosis of allergy: 1) Clinical data were collected from a questionnaire and medical records. 2) No premedication was administered but, instead, oxygen, epinephrine and a resuscitation cart were accessible. 3) Following the procedure, each patient was observed for one hour and contacted by telephone 24 hrs later. No allergic responses were documented in the medical records of 1515 subjects following sialo-CBCT studies, including 13 individuals previously diagnosed with ICM allergy. Investigation of the subgroup with prior allergy disclosed that the range of injected volume was between 2 ml to 6.2 ml per patient and that complete secretion of ICM was detected in 7 of 13 patients. In the remainder of subjects, retention rates of 5-50% were observed. Allergic reactions are exceedingly rare following sialo-CBCT studies regardless of a previous diagnosis of allergy. Pre-medication with corticosteroids and antihistamines is usually not warranted.

Advanced cardiac life support (ACLS) skills are essential for nurses. During the COVID-19 pandemic, augmented reality (AR) technologies were incorporated into medical education to increase learning motivation and accessibility. This study aims to determine whether AR for educational applications can significantly improve crash cart learning, learning motivation, cognitive load, and system usability. It focused on a subgroup of nurses with less than 2 years of experience. This randomized controlled trial study was conducted in a medical center in southern Taiwan. An ACLS cart training course was developed using AR technologies in the first stage. Additionally, the efficacy of the developed ACLS training course was evaluated. The AR group used a crash cart learning system developed with AR technology, while the control group received traditional lecture-based instruction. Both groups were evaluated immediately after the course. Performance was assessed through learning outcomes related to overall ACLS and crash cart use. The Instructional Materials Motivation Survey, System Usability Scale, and Cognitive Load Theory Questionnaire were also used to assess secondary outcomes in the AR group. Subgroup analyses were performed for nurses with less than 2 years of experience. All 102 nurses completed the course, with 43 nurses in the AR group and 59 nurses in the control group. The AR group outperformed the control group regarding overall ACLS outcomes and crash cart learning outcomes (P=.002; P=.01). The improvement rate was the largest for new staff regardless of the overall learning effect and the crash cart effect. Subgroup analysis revealed that nurses with less than 2 years of experience in the AR group showed more significant improvements in both overall learning (P<.001) and crash cart outcomes (P<.001) compared to their counterparts in the control group. For nurses with more than 2 years of experience, no significant differences were found between the AR and control groups in posttraining learning outcomes for the crash cart (P=.32). The AR group demonstrated high scores for motivation (Instructional Materials Motivation Survey mean score 141.65, SD 19.25) and system usability (System Usability Scale mean score 90.47, SD 11.91), as well as a low score for cognitive load (Cognitive Load Theory Questionnaire mean score 15.42, SD 5.76). AR-based learning significantly improves ACLS knowledge and skills, especially for nurses with less experience, compared to traditional methods. The high usability and motivational benefits of AR suggest its potential for broader applications in nursing education. ClinicalTrials.gov NCT06057285; https://clinicaltrials.gov/ct2/show/NCT06057285.