使用音频审查标准化工具评估院外心脏骤停期间的调度员心肺复苏表现。
Assessment of telecommunicator cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest using a standardized tool for audio review.
机构信息
Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, 2139 Cardiovascular Center, Ann Arbor, MI 48109, United States; Department of Learning Health Sciences, University of Michigan Medical School, 209 Victor Vaughan Building, 2054, 1111 East Catherine Street, Ann Arbor, MI 48109, United States; Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Road, North Campus Research Complex (NCRC), Building 16, Ann Arbor, MI 48109, United States.
Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States; Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Building 10-A103, North Campus Research Complex (NCRC), 2800 Plymouth Road, Ann Arbor, MI 48109, United States.
出版信息
Resuscitation. 2022 Sep;178:102-108. doi: 10.1016/j.resuscitation.2022.04.015. Epub 2022 Apr 26.
OBJECTIVE
Telecommunicator cardiopulmonary resuscitation (T-CPR) is a critical component of optimized out-of-hospital cardiac arrest (OHCA) care. We assessed a pilot tool to capture American Heart Association (AHA) T-CPR measures and T-CPR coaching by telecommunicators using audio review.
METHODS
Using a pilot tool, we conducted a retrospective review of 911 call audio from 65 emergency medical services-treated out-of-hospital cardiac arrest (OHCA) patients. Data collection included events (e.g., OHCA recognition), time intervals, and coaching quality measures. We calculated summary statistics for all performance and quality measures.
RESULTS
Among 65 cases, the patients' mean age was 64.7 years (SD: 14.6) and 17 (26.2%) were women. Telecommunicator recognition occurred in 72% of cases (47/65). Among 18 non-recognized cases, reviewers determined 12 (66%) were not recognizable based on characteristics of the call. Median time-to-recognition was 76 seconds (n = 40; IQR:39-138), while median time-to-first-instructed-compression was 198 seconds (n = 26; IQR:149-233). In 36 cases where coaching was needed, coaching on compression-depth occurred in 27 (75%); -rate in 28 (78%); and chest recoil in 10 (28%) instances. In 30 cases where repositioning was needed, instruction to position the patient's body flat occurred in 18 (60%) instances, on-back in 22 (73%) instances, and on-ground in 22 (73%) instances.
CONCLUSIONS
Successful collection of data to calculate AHA T-CPR measures using a pilot tool for audio review revealed performance near AHA benchmarks, although coaching instructions did not occur in many instances. Application of this standardized tool may aid in T-CPR quality review.
目的
远程心肺复苏（T-CPR）是优化院外心脏骤停（OHCA）护理的重要组成部分。我们评估了一种通过音频审查来捕捉美国心脏协会（AHA）T-CPR 措施和 T-CPR 指导的试点工具。
方法
使用试点工具，我们对 65 例接受紧急医疗服务治疗的院外心脏骤停（OHCA）患者的 911 呼叫音频进行了回顾性审查。数据收集包括事件（例如，OHCA 识别）、时间间隔和指导质量措施。我们计算了所有性能和质量措施的汇总统计数据。
结果
在 65 例病例中，患者的平均年龄为 64.7 岁（标准差：14.6），17 例（26.2%）为女性。在 72%的病例（47/65）中，远程通讯器识别发生。在 18 例未识别的病例中，审核人员根据呼叫的特征确定 12 例（66%）不可识别。中位数识别时间为 76 秒（n=40；IQR：39-138），中位数首次指令按压时间为 198 秒（n=26；IQR：149-233）。在需要指导的 36 例病例中，对按压深度进行指导的有 27 例（75%）；对按压速率进行指导的有 28 例（78%）；对胸部回弹进行指导的有 10 例（28%）。在需要重新定位的 30 例病例中，有 18 例（60%）需要指导将患者身体放平，22 例（73%）需要指导将患者背部朝上，22 例（73%）需要指导将患者放在地上。
结论
使用试点工具通过音频审查成功收集数据来计算 AHA T-CPR 措施，结果显示性能接近 AHA 基准，尽管在许多情况下并未进行指导。应用这种标准化工具可能有助于 T-CPR 质量审查。
Zotero 插件