Cardiac Arrest
Conditions
Keywords
Cardiac arrest, CPR, quality improvement
Brief summary
The investigators will quantify the quality of chest compressions provided in the Emergency Department and determine whether the quality of chest compressions is related to patient outcome. The quality of chest compressions and patient outcomes will be assessed both before and after the introduction of audiovisual feedback in real time.
Detailed description
The Emergency Department will be using E-series unit manufactured by ZOLL Medical Group (Chelmsford, MA). These units are equipped with an accelerometer-based system that allows for measurement of chest compression depth and rate. These units are also equipped with RealCPRHelp, and FDA-approved technology that provides real-time audiovisual feedback to providers on the quality of chest compressions. In the first phase of the project, the ED providers will utilize the E-series units to treat all patients requiring chest compressions.
Interventions
BEHAVIORALscenario-based training, real-time audiovisual CPR feedback, and post-event debriefing
scenario-based training for CPR, real-time audiovisual CPR feedback using R Series monitor-defibrillator during treatment, and post-event debriefing
Sponsors
Valleywise Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Chest Compression before and after RealCPRHelp
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years old or older
Exclusion criteria
* less than 18 years old
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CPR Quality | during CPR | Chest Compression Release Velocity |
| CPR Quality-compression Fraction | During CPR | Chest Compression Fraction indicating the percentage of time in which chest compressions are done by rescuers during a cardiac arrest |
| CPR Quality-Chest Compression Rate | During CPR | Mean Chest Compression Rate |
| CPR Quality-compression Depth | during CPR | Measurement of chest compression depth |
| CPR Quality-percent of >51mm Compressions | during CPR | Percent of Chest Compressions greater than 51mm |
| CPR Quality- Pre-shock Pause | During CPR | Pre-shock pause: time from cessation of CPR to shock delivery |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Phase I Before training | 52 |
| Phase 2 After training. | 49 |
| Total | 101 |
Baseline characteristics
| Characteristic | Phase I | Phase 2 | Total |
|---|---|---|---|
| Age, Customized Mean Age of participants | 56 years | 60 years | 58 years |
| Sex: Female, Male Female | 19 Participants | 8 Participants | 27 Participants |
| Sex: Female, Male Male | 33 Participants | 41 Participants | 74 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 52 | 0 / 49 |
| other Total, other adverse events | 0 / 52 | 0 / 49 |
| serious Total, serious adverse events | 0 / 52 | 0 / 49 |
Outcome results
Primary
CPR Quality
Chest Compression Release Velocity
Time frame: during CPR
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Before Training | CPR Quality | 314 mm/s |
| After Training. | CPR Quality | 442 mm/s |
p-value: <0.001Kruskal-Wallis
Primary
CPR Quality-Chest Compression Rate
Mean Chest Compression Rate
Time frame: During CPR
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Before Training | CPR Quality-Chest Compression Rate | 125 CCs/min |
| After Training. | CPR Quality-Chest Compression Rate | 125 CCs/min |
p-value: 0.65Kruskal-Wallis
Primary
CPR Quality-compression Depth
Measurement of chest compression depth
Time frame: during CPR
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Before Training | CPR Quality-compression Depth | 46.7 mm |
| After Training. | CPR Quality-compression Depth | 61.6 mm |
Primary
CPR Quality-compression Fraction
Chest Compression Fraction indicating the percentage of time in which chest compressions are done by rescuers during a cardiac arrest
Time frame: During CPR
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Before Training | CPR Quality-compression Fraction | 84.3 % of time chest compressions are done |
| After Training. | CPR Quality-compression Fraction | 88.4 % of time chest compressions are done |
p-value: 0.1Kruskal-Wallis
Primary
CPR Quality-percent of >51mm Compressions
Percent of Chest Compressions greater than 51mm
Time frame: during CPR
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Before Training | CPR Quality-percent of >51mm Compressions | 30.6 percentage of chest compressions >51mm |
| After Training. | CPR Quality-percent of >51mm Compressions | 87.4 percentage of chest compressions >51mm |
p-value: <0.001Kruskal-Wallis
Primary
CPR Quality- Pre-shock Pause
Pre-shock pause: time from cessation of CPR to shock delivery
Time frame: During CPR
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Before Training | CPR Quality- Pre-shock Pause | 9.7 sec |
| After Training. | CPR Quality- Pre-shock Pause | 5.9 sec |