The Children's Hospital of Philadelphia, Department of Anesthesia and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Resuscitation. 2012 Dec;83(12):1462-6. doi: 10.1016/j.resuscitation.2012.05.010. Epub 2012 May 24.
Performance of high quality CPR is associated with improved resuscitation outcomes. This study investigates code leader ability to recall CPR error during post-event interviews when CPR recording/audiovisual feedback-enabled defibrillators are deployed.
Physician code leaders were interviewed within 24h of 44 in-hospital pediatric cardiac arrests to assess their ability to recall if CPR error occurred during the event. Actual CPR quality was assessed using quantitative recording/feedback-enabled defibrillators. CPR error was defined as an overall average event chest compression (CC) rate <95/min, depth < 38 mm, ventilation rate >10/min, or any interruptions in CPR >10s. We hypothesized that code leaders would recall error when it actually occurred ≥ 75% of the time when assisted by audiovisual alerts from a CPR recording feedback-enabled defibrillators (analysis by χ(2)).
810 min from 44 cardiac arrest events yielded 40 complete data sets (actual and interview); ventilation data was available in 24. Actual CPR error was present in 3/40 events for rate, 4/40 for depth, 32/40 for interruptions >10s, and 17/24 for ventilation frequency. In post-event interviews, code leaders recalled these errors in 0/3 (0%) for rate, 0/4 (0%) for depth, and 19/32 (59%) for interruptions >10s. Code leaders recalled these CPR quality errors less than 75% of the time for rate (p=0.06), for depth (p<0.01), and for CPR interruption (p=0.04). Quantification of errors not recalled: missed rate error median=94 CC/min (IQR 93-95), missed depth error median=36 mm (IQR 35.5-36.5), missed CPR interruption >10s median=18s (IQR 14.4-28.9). Code leaders did recall the presence of excessive ventilation in 16/17 (94%) of events (p=0.07).
Despite assistance by CPR recording/feedback-enabled defibrillators, pediatric code leaders fail to recall important CPR quality errors for CC rate, depth, and interruptions during post-cardiac arrest interviews.
高质量的心肺复苏（CPR）操作与改善复苏结果相关。本研究调查了在使用配备心肺复苏记录/视听反馈除颤器的情况下，当事件发生后进行回顾性采访时，复苏团队的领导者能否回忆起 CPR 中的失误。
对 44 例院内儿科心搏骤停的医师复苏团队领导者在事件发生后 24 小时内进行采访，以评估他们是否能回忆起事件中是否发生了 CPR 失误。实际的 CPR 质量使用配备定量记录/反馈的除颤器进行评估。CPR 失误被定义为总的平均事件胸外按压（CC）频率<95 次/分、深度<38 毫米、通气频率>10 次/分，或任何中断>10 秒。我们假设当配备心肺复苏记录反馈除颤器的视听警报辅助时，复苏团队领导者能回忆起失误的次数≥75%（分析用 χ(2)）。
44 次心搏骤停事件的 810 分钟中，有 40 个完整的数据组（实际数据和采访数据）；有 24 个通气数据可用。3/40 个事件中存在按压频率的实际 CPR 失误，4/40 个事件中存在按压深度的实际 CPR 失误，32/40 个事件中存在>10 秒的中断，17/24 个事件中存在通气频率的实际 CPR 失误。在事后采访中，0/3（0%）个事件的复苏团队领导者回忆起按压频率的失误，0/4（0%）个事件的复苏团队领导者回忆起按压深度的失误，19/32（59%）个事件的复苏团队领导者回忆起>10 秒的中断的失误。在按压频率（p=0.06）、按压深度（p<0.01）和 CPR 中断（p=0.04）方面，复苏团队领导者回忆起这些 CPR 质量失误的次数不到 75%。没有回忆起来的失误量化值：错过的按压频率失误中位数=94 CC/min（IQR 93-95），错过的按压深度失误中位数=36 毫米（IQR 35.5-36.5），错过的>10 秒的 CPR 中断失误中位数=18 秒（IQR 14.4-28.9）。复苏团队领导者确实回忆起 16/17（94%）个事件中存在过度通气（p=0.07）。
尽管有配备心肺复苏记录/反馈除颤器的辅助，但在心脏骤停后进行回顾性采访时，儿科复苏团队的领导者仍无法回忆起 CC 频率、深度和中断等重要的 CPR 质量失误。
