Ford James S, Malhotra Atul, Pearce Alex K, Wardi Gabriel
Department of Emergency Medicine, University of California San Diego, San Diego, CA, United States of America.
Department of Medicine, University of California San Diego, San Diego, CA, United States of America.
Am J Emerg Med. 2025 Jun 23;96:166-169. doi: 10.1016/j.ajem.2025.06.056.
Advanced Cardiovascular Life Support (ACLS) knowledge and skills retention is poor among clinicians. Deviations from ACLS guidelines are common and are associated with worse outcomes and less experienced code leaders often feel unprepared to lead resuscitations.
To develop a schematic for assisting code leaders in managing the initial phase of cardiac arrest resuscitations.
We reviewed the medical literature evaluating the effectiveness and timing of ACLS interventions in adult cardiac arrest, with a focus on identifying tasks most strongly associated with patient-centered outcomes and those most closely aligned with existing ACLS protocols. Four clinical content experts assessed the literature and independently ranked tasks to be included in the mnemonic; the final ranked list was approved by consensus discussion. We then incorporated our ranked list into a mnemonic using principles of cognitive load theory, including chunking, serial recall, and the primacy effect.
We identified five early interventions with strong evidence supporting their impact on outcomes. These interventions form the core of "CPADS-30", a simplified mnemonic designed to facilitate memory recall and facilitate task delegation in the first 30 s of cardiac arrest resuscitation. These tasks include C (Chest compressions), P (Pad [defibrillator] placement), A (Access [intravenous/intraosseous]), D (Drug administration) and S (Scribe assignment).
"CPADS-30" distills down critical early actions of cardiac arrest management into a discreet, digestible schematic that complements the complete ACLS algorithm. We hope "CPADS-30" will prove useful to trainees and providers of all levels of training in various practice environments.
临床医生对高级心血管生命支持(ACLS)知识和技能的掌握情况较差。与ACLS指南的偏差很常见,且与更差的预后相关,经验不足的急救负责人往往觉得没有准备好领导复苏工作。
制定一个示意图,以协助急救负责人管理心脏骤停复苏的初始阶段。
我们回顾了评估ACLS干预措施在成人心脏骤停中有效性和时机的医学文献,重点是确定与以患者为中心的预后最密切相关的任务以及与现有ACLS协议最一致的任务。四位临床内容专家评估了文献,并独立对纳入记忆法的任务进行排名;最终的排名列表经共识讨论后获得批准。然后,我们运用认知负荷理论的原则,包括组块、序列回忆和首因效应,将排名列表纳入一个记忆法中。
我们确定了五项早期干预措施,有强有力的证据支持它们对预后的影响。这些干预措施构成了“CPADS-30”的核心,这是一个简化的记忆法,旨在促进记忆回忆,并便于在心脏骤停复苏的前30秒进行任务分配。这些任务包括C(胸外按压)、P(放置[除颤器]电极片)、A(建立[静脉/骨内]通路)、D(给药)和S(指定记录员)。
“CPADS-30”将心脏骤停管理的关键早期行动提炼成一个简洁、易于理解的示意图,对完整的ACLS算法起到补充作用。我们希望“CPADS-30”对不同实践环境中各级培训的学员和提供者有用。