Hands-On Times, Adherence to Recommendations and Variance in Execution among Three Different CPR Algorithms: A Prospective Randomized Single-Blind Simulator-Based Trial

Sami Rifai, Timur Sellmann, Dietmar Wetzchewald, Heidrun Schwager, Franziska Tschan, Sebastian G. Russo and Stephan Marsch
Additional contact information
Sami Rifai: Department of Orthopedics and Trauma Surgery, Bethesda Hospital, 47053 Duisburg, Germany
Timur Sellmann: Department of Anaesthesiology and Intensive Care, Bethesda Hospital, 47053 Duisburg, Germany
Dietmar Wetzchewald: Institution for Emergency Medicine, 59755 Arnsberg, Germany
Heidrun Schwager: Institution for Emergency Medicine, 59755 Arnsberg, Germany
Franziska Tschan: Department of Psychology, University of Neuchatel, 2000 Neuchâtel, Switzerland
Sebastian G. Russo: Department of Anaesthesiology, University of Witten/Herdecke, 58448 Witten, Germany
Stephan Marsch: Department of Intensive Care, University Hospital, 4031 Basel, Switzerland

IJERPH, 2020, vol. 17, issue 21, 1-12

Abstract: Background: Alternative cardiopulmonary resuscitation (CPR) algorithms, introduced to improve outcomes after cardiac arrest, have so far not been compared in randomized trials with established CPR guidelines. Methods: 286 physician teams were confronted with simulated cardiac arrests and randomly allocated to one of three versions of a CPR algorithm: (1) current International Liaison Committee on Resuscitation (ILCOR) guidelines (“ILCOR”), (2) the cardiocerebral resuscitation (“CCR”) protocol (3 cycles of 200 uninterrupted chest compressions with no ventilation), or (3) a local interpretation of the current guidelines (“Arnsberg“, immediate insertion of a supraglottic airway and cycles of 200 uninterrupted chest compressions). The primary endpoint was percentage of hands-on time. Results: Median percentage of hands-on time was 88 (interquartile range (IQR) 6) in “ILCOR” teams, 90 (IQR 5) in “CCR” teams ( p = 0.001 vs. “ILCOR”), and 89 (IQR 4) in “Arnsberg” teams ( p = 0.032 vs. “ILCOR”; p = 0.10 vs. “CCR”). “ILCOR” teams delivered fewer chest compressions and deviated more from allocated targets than “CCR” and “Arnsberg” teams. “CCR” teams demonstrated the least within-team and between-team variance. Conclusions: Compared to current ILCOR guidelines, two alternative CPR algorithms advocating cycles of uninterrupted chest compressions resulted in very similar hands-on times, fewer deviations from targets, and less within-team and between-team variance in execution.

Keywords: cardiopulmonary resuscitation (CPR); guidelines; cardiocerebral resuscitation; adherence; simulation; randomized trial (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: Add references at CitEc
Citations: View citations in EconPapers (1)

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