How do you perform CPR? Q-CPR: A system for control CPR

S50

Abstracts / Resuscitation 81S (2010) S1–S114

AP062

AP064

Chest compression quality in healthcare professionals

Monitoring possibilities of resuscitation efforts during cath-lab resuscitation

Semeraro F., Tammaro G., Imbriaco G., Taggi F., Cerchiari E.L.

Wagner H. 1 , Härdig B.M. 2 , Harnek J. 1 , Götberg M. 1 , Olivecrona G.K. 1

Department of Anaesthetics and Intensive Care, Maggiore Hospital, Bologna, Italy

1 Departement 2

Purpose of the study: Cardiopulmonary resuscitation has been known as one of the determinants of survival in cardiac arrest and the quality of the resuscitation provided also correlates with outcome. Tools analyzing compressions and ventilations and providing feedback to the operator performing CPR, have been shown to improve CPR performance. This study was undertaken to assess the quality of cardiac compressions provided by healthcare personnel of the Maggiore Hospital Bologna, analyzed in a simulated session with and without audiovisual feedback (FB). Materials and methods: All hospital personnel was invited to participate in a simulated session to evaluate the proficiency in cardiac compressions (CC). Each participant was asked to perform a trial of 2 min of CC, answer a predefined set of questions and then perform 2 more minutes of CC. Participants were randomized to one of two groups, the first performing the sequence CC with feedback-questions-CC without feedback and the second the sequence CC without feedback-questions-CC with feedback. We use a commercially available monitor/defibrillator with CPR quality and audio recording capabilities (MRx-QCPR, Philips Medical Systems). We use also a Resusci Anne manikin and data regarding the quality of CPR were collected with Q-CPR Review (Laerdal Medical). Results: We present a preliminary data on 72 participants. The age of the participants was 38 ± 8.4. The mean compression rate was 109.26 ± 25.61 min−1 when chest compressions were performed without feedback and 104.77 ± 13.03 min−1 when performed with feedback (p < 0.01). The average compression depth was 46.37 ± 12.73 mm without and 44.48 ± 5.87 with Q-CPR guidance (p < 0.01). Conclusions: We confirm previous study about the effectiveness of quality CPR feedback on chest compressions quality and we will evaluate at the end of this study the correlation with previous CPR training of each participants.

of Cardiology, University Hospital of Lund Sweden Jolife AB Lund Sweden

Purpose of study: Cardiac arrest situations are often dramatic and it is difficult to perform studies on this patient category. In cardiac arrest situations in the cath-lab when prolonged resuscitation efforts are needed, the introduction of mechanical chest compression devices has shown promise to reduce mortality during continued percutaneous coronary interventions. We hypothesized that a continuous monitoring system in the cath-lab with the ability to save large data files could be used to depth analyze the vital parameters and resuscitation related parameters during resuscitation efforts in individual patients. Materials and methods: For mechanical chest compressions in the cath-lab, the LUCAS 1 V1US (Jolife AB, Lund, Sweden) was used. Hemodynamic measurements, ETCO2 and O2 saturation was collected every 2nd ms. Results: In one patient we were able to closely monitor arterial pressure and SpO2 from the start of coronary angiogram until the patient left the cath-lab after 90 min. Circulation was maintained with mechanical chest compressions for 52 min until he obtained ROSC. We were able to monitor ETCO2 for 50 min and venous pressure the last 30 min of resuscitation. The physiology parameters during 52 min of resuscitation and simultaneous percutaneous coronary interventions and during a 10 min period after return of spontaneous circulation was registered. Conclusion: The setting with mechanical chest compression devices in the cath-lab for prolonged resuscitation alone or as a bridge to full cardio pulmonary support, brings further knowledge of vital parameter’s response to mechanical chest compression and pharmacological substances during resuscitation efforts. doi:10.1016/j.resuscitation.2010.09.209 AP065

doi:10.1016/j.resuscitation.2010.09.207 How do you perform CPR? Q-CPR: A system for control CPR AP063 Nurses competence in providing CPR Horschitzka S. 1 , Steininger A. 2 , Jukic-Puntigam M. 3 , Zinka B. 4 , Gross D. 5 , Müller G. 6 1 Academy

of Nursing, St. John of God, Vienna, Austria Academy of Nursing, St. John of God, Vienna, Austria Academy of Nursing, St. John of God, Vienna, Austria 4 Academy of Nursing, St. John of God, Vienna, Austria 5 Department of Nursing Science and Gerontology, UMIT-The Health & Life Sciences University, Vienna, Austria 6 Department of Nursing Science and Gerontology, UMIT-The Health & Life Sciences University, Vienna, Austria 2 3

Purpose of the study: The aim of this paper is to show if CPR-training (cardiopulmonary resuscitation) is able to improve nurses’ resuscitation skills. If yes, the author points out how this should be done. Materials and methods: A research of the literature should answer the following question: Do registered nurses, who regularly exercise CPR during training, better perform in doing CPR than those, who never or not regularly attend a CPR training? Furthermore, the author suggests a CPR-training regarding their effectiveness and points out useful intervals between trainings. Literature was recruited through Medline and CINAHL (Cumulative Index to Nursing and Allied Health Literature), finally eight studies were chosen to be included. Results: Broomfield (1996) showed that training is able to improve nurses’ resuscitation skills. Castle et al. (2007) pointed out that BLS skills – thanks to better trainings – increased since 1987, when nurses’ lack of providing BLS was first shown. Several studies show that the time span between trainings should not cover more than six to a maximum of twelve months (Castle et al., 2007; Mäkinen et al., 2006; Cooper, 1999; Broomfield, 1996). Training should consist out of two parts: a theoretical part, which could be done at home over the internet and a practical part where nurses should practice CPR under supervision in small groups having as much time as they need to be confident in resuscitation (Mäkinen et al., 2006; Davies and Gould, 2000). Conclusions: Nurses, who know exactly what to do in case of a cardiac arrest, can improve patients’ survival outcome. Effective and regular CPR-Training in concern of bestpractice should therefore be a challenge for nursing. doi:10.1016/j.resuscitation.2010.09.208

Leis C., Hernández R., Paterna P.C., González V., Ochoa M.J., Torres E. SAMUR- Protección Civil, Ayuntamiento de Madrid, Spain Introduction: SAMUR is a prehospital emergency medical service. Aiming to improve survival of patients in cardiac arrest, Q-CPR device has been implemented. This system allows measurement and feedback on compression depth, rate, trends and CPR interruptions. In this study, the relation between survival rates and the compressions in CPR has been analyzed. Methods: The research team linked the quality of CPR delivered using the Q-CPR device with the survival of the patients who suffered from an OOHCA. Age, gender, initial cardiac rhythm, previous Basic Life Support manoeuvres and response time were also considered. Methodology used is descriptive, analytical with data collection processed with Excel and SPSS v 17.0. Results: We have studied 73 OOHCA treated with Q-CPR and 654 treated without Q-CPR from November 27th, 2007 until April 15th, 2010. Survival of patients treated with Q-CPR is higher than those treated without Q-CPR. (Q-CPR 46.8% ROSC and No QCPR 39.7%). Although no statistical significance was found, survival rate is higher than expected. We also found higher survival rates in 6 (Q-CPR: 63.4%, no Q-CPR 60.1%), 24 h (Q-CPR 53.7%, no Q-CPR 52.4%) and 7 days (Q-CPR 43.9%, no Q-CPR 33.8%) with Q-CPR (no statistical significance). There no differences between age, gender, initial rhythm, previous Basic Life Support manoeuvres and response time. Incomplete chest recoil have been linked with statistically significant relationship (p < 0.05) between ROSC and survival to 24 h. Deep compressions rate have been related to survival to 6 h with statistically significance. Conclusions: Quality of CPR in order to improve the survival rate of patients in cardiac arrest should be analyzed. Allowing the chest to return to its normal position and making deep compressions, can make the difference in improving survival. The use of Q-CPR improves the survival of patients in cardiac arrest and seem to be necessary for the training of professionals. doi:10.1016/j.resuscitation.2010.09.210