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Unnecessary interruptions of cardiac massage during simulated cardiac arrests

Published online by Cambridge University Press:  13 October 2005

S. C. U. Marsch ,
F. Tschan ,
N. Semmer ,
M. Spychiger ,
M. Breuer  and
P. R. Hunziker
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
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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.

Keywords

RESUSCITATIONCARDIOPULMONARY RESUSCITATIONHEART MASSAGEADVANCED LIFE SUPPORTTEACHINGPATIENT SIMULATION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 11 , November 2005 , pp. 831 - 833
Copyright
© 2005 European Society of Anaesthesiology

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