Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-28T10:45:48.413Z Has data issue: false hasContentIssue false

Unnecessary interruptions of cardiac massage during simulated cardiac arrests

Published online by Cambridge University Press:  13 October 2005

S. C. U. Marsch
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
F. Tschan
Affiliation:
University of Neuchâtel, Department of Psychology, Neuchâtel, Switzerland
N. Semmer
Affiliation:
University of Bern, Department of Psychology, Bern, Switzerland
M. Spychiger
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
M. Breuer
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
P. R. Hunziker
Affiliation:
University of Basel, Medical Intensive Care Unit, Basel, Switzerland
Get access

Extract

Summary

Background and objective: Cardiopulmonary resuscitation should not be interrupted until the return of spontaneous circulation or the decision to withhold further treatment. There are no data on how consistent in-hospital cardiopulmonary resuscitation is performed. Accordingly, the aim of the present study was to identify length and type of unnecessary interruptions in simulated cardiac arrests. Methods: The study was carried out in a patient simulator. A scenario of cardiac arrest due to ventricular fibrillation was used. Resuscitation teams consisted of three nurses, a resident and a staff physician. Using videotapes recorded during simulations, the activities of the teams were coded in 5-s intervals. Unnecessary interruptions were defined as any interruptions in cardiac massage of 10 s or more that were not caused by defibrillation or endotracheal intubation. Results: Twelve teams were studied. The total time of possible cardiac massage was 414 ± 125 s. In each team at least one unnecessary interruption occurred (range 1–5). Interruptions mounted up to 65 ± 40 s (range 20–155) or 16 ± 10% (range 5–41) of the total time of possible cardiac massage. Failure to swiftly resume cardiac massage after an unsuccessful defibrillation accounted for 14 of 39 episodes and for 44 ± 40% of the time of unnecessary interruptions. The debriefings revealed that participants had generally not noticed the unnecessary interruptions during the simulation. Conclusions: The present study identified a significant amount of unnecessary interruptions in cardiac massage. These interruptions were not noticed by the health-care workers involved.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation 2002; 105: 645649.Google Scholar
Sato Y, Weil MH, Sun S et al. Adverse effects of interrupting precordial compression during cardiopulmonary resuscitation. Crit Care Med 1997; 25: 733736.Google Scholar
Yu T, Weil MH, Tang W et al. Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation 2002; 106: 368372.Google Scholar
van Alem AP, Sanou BT, Koster RW. Interruption of cardiopulmonary resuscitation with the use of the automated external defibrillator in out-of-hospital cardiac arrest. Ann Emerg Med 2003; 42: 449457.Google Scholar
Peberdy MA, Kaye W, Ornato JP et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 2003; 58: 297308.Google Scholar
Cooper S, Wakelam A. Leadership of resuscitation teams: ‘Lighthouse Leadership’. Resuscitation 1999; 42: 2745.Google Scholar
Mann CJ, Heyworth J. Comparison of cardiopulmonary resuscitation techniques using video camera recordings. Emerg Med J 1996; 13: 198199.Google Scholar