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基于数据的心肺复苏后汇报:一项随机对照试验。

Data-informed debriefing for cardiopulmonary arrest: A randomized controlled trial.

作者信息

Cheng Adam, Davidson Jennifer, Wan Brandi, St-Onge-St-Hilaire Alexandra, Lin Yiqun

机构信息

Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Research Program, Alberta Children's Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.

KidSIM Simulation Program, Alberta Children's Hospital, University of Calgary, Canada.

出版信息

Resusc Plus. 2023 May 25;14:100401. doi: 10.1016/j.resplu.2023.100401. eCollection 2023 Jun.

Abstract

AIM

To determine if data-informed debriefing, compared to a traditional debriefing, improves the process of care provided by healthcare teams during a simulated pediatric cardiac arrest.

METHODS

We conducted a prospective, randomized trial. Participants were randomized to a traditional debriefing or a data-informed debriefing supported by a debriefing tool. Participant teams managed a 10-minute cardiac arrest simulation case, followed by a debriefing (i.e. traditional or data-informed), and then a second cardiac arrest case. The primary outcome was the percentage of overall excellent CPR. The secondary outcomes were compliance with AHA guidelines for depth and rate, chest compression (CC) fraction, peri-shock pause duration, and time to critical interventions.

RESULTS

A total of 21 teams (84 participants) were enrolled, with data from 20 teams (80 participants) analyzed. The data-informed debriefing group was significantly better in percentage of overall excellent CPR (control vs intervention: 53.8% vs 78.7%; MD 24.9%, 95%CI: 5.4 to 44.4%,  = 0.02), guideline-compliant depth (control vs. intervention: 60.4% vs 85.8%, MD 25.4%, 95%CI: 5.5 to 45.3%,  = 0.02), CC fraction (control vs intervention: 88.6% vs 92.6, MD 4.0%, 95%CI: 0.5 to 7.4%,  = 0.03), and peri-shock pause duration (control vs intervention: 5.8 s vs 3.7 s, MD -2.1 s, 95%CI: -3.5 to -0.8 s,  = 0.004) compared to the control group. There was no significant difference in time to critical interventions between groups.

CONCLUSION

When compared with traditional debriefing, data-informed debriefing improves CPR quality and reduces pauses in CPR during simulated cardiac arrest, with no improvement in time to critical interventions.

摘要

目的

确定与传统的总结汇报相比,基于数据的总结汇报是否能改善医疗团队在模拟小儿心脏骤停期间提供的护理过程。

方法

我们进行了一项前瞻性随机试验。参与者被随机分为传统总结汇报组或由总结汇报工具支持的基于数据的总结汇报组。参与团队处理一个10分钟的心脏骤停模拟病例,随后进行总结汇报(即传统的或基于数据的),然后再处理第二个心脏骤停病例。主要结局是总体高质量心肺复苏(CPR)的百分比。次要结局包括符合美国心脏协会(AHA)关于按压深度和速率的指南情况、胸外按压(CC)比例、电击前后暂停时间以及关键干预措施的实施时间。

结果

共招募了21个团队(84名参与者),分析了20个团队(80名参与者)的数据。与对照组相比,基于数据的总结汇报组在总体高质量CPR百分比(对照组 vs 干预组:53.8% vs 78.7%;平均差值[MD] 24.9%,95%置信区间[CI]:5.4%至44.4%,P = 0.02)、符合指南的按压深度(对照组 vs 干预组:60.4% vs 85.8%,MD 25.4%,95%CI:5.5%至45.3%,P = 0.02)、CC比例(对照组 vs 干预组:88.6% vs 92.6%,MD 4.0%,95%CI:0.5%至7.4%,P = 0.03)以及电击前后暂停时间(对照组 vs 干预组:5.8秒 vs 3.7秒,MD -2.1秒,95%CI:-3.5至-0.8秒,P = 0.004)方面表现明显更好。两组在关键干预措施的实施时间上没有显著差异。

结论

与传统总结汇报相比,基于数据的总结汇报可提高CPR质量并减少模拟心脏骤停期间CPR的中断时间,但在关键干预措施的实施时间方面没有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49c8/10227448/9e734d2e7d9d/gr1.jpg

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