Cardiopulmonary Resuscitation Clinical Trial
Official title:
Cardiopulmonary Resuscitation Training Program Based on Quality Control in Gottsegen György Hungarian Institute of Cardiology
In a prospective, non-randomized study, all of the basic and advanced cardiopulmonary
resuscitations would be analyzed. All resuscitation are planned to be performed by the above
mentioned devices according to the recent protocols. The continuous audio-visual feedback
and all the data obtained during the resuscitation are intended to develop a better CPR
training program in the future.
The downloading of data is planned to occur on the same day of CPR to a data card. After
approximately one week all the participant medical persons would receive a detailed case
analysis. Elimination of the typical errors is targeted.
Monitored quality indicators
Follow-up of CPR protocol:
elapsed time between turning on device and first chest compression elapsed time between
turning on device and first delivered shock elapsed time between turning on device and first
delivered shock in case of shockable rhythm compliance with 2 minutes long CPR period
recognition of rhythm, recognition of adequate therapy, follow-up of the protocol concerning
DC-shock recording the exact moment of the following procedures (with the use of Code Marker
button on the defibrillator device) endotracheal intubation drug therapy obtaining
intravenous access oxygen therapy
Quality of chest compressions:
depth frequency release compression fraction
Discontinuance of chest compression - cause anf time interval (Code Marker) endotracheal
intubation ventilation rhythm analysis and defibrillation obtaining intravenous access
Other data (obtaining with manual recording):
cause of sudden cardiac death initial rhythm exact time of sudden death eyewitness records
data of the patient monitoring system (only optional) description of place participant of
CPR first detection medical documentation
Sudden cardiac death remains the leading cause of morbidity and mortality and has public
health importance. In recent decades, the pathophysiology became better known, however
despite the development of medical devices and therapies, significant improvement in outcome
was not observed, survival of patients remained low REF1-4.
The resuscitation protocols are based on universal algorithms REF5-6, are valid for all
health care practitioners regardless of qualifications, skills. This reanimation paradigm
focuses on the basic skills (chest compression, respiration) REF7-8. On the basis of
investigations, the most important factors would be: continuous, high-quality chest
compressions with the possibly of shortest interruptions REF9, however, the performance of
this practice has significant difficulties to meet the expectations REF10.
Without relevant data, the meaningful assessment, follow-up and analysis of resuscitation
are difficult, so a substantive case-based training is not feasible.
A reanimation training program on the basis of continuous audio-visual feedback, data and
case report would be needed to improve the poor outcome.
A study proved that audio-visual cardiopulmonary resuscitation (CPR) feedback, case analysis
and scenario-based training can improve significantly the parameters of basic life support
(BLS) and can increase the odds of a better neurological survival status after sudden
cardiac arrest outside a hospital - adjusted odds ratio (AOR) 2.7 REF11.
Another study REF12 demonstrated that this method in a hospital environment can improve CPR
quality indicators. The so-called Advanced Resuscitation the framework program has also
achieved a significant leap from the hospital survival (AOR 2.2, good neurological status
AOR 3.0) with similar methods and technology REF13. These results show that an increase in
the survival can be achieved with the improvement of resuscitation method and training.
Advanced life support (ALS) service in the Gottsegen György Hungarian Institute of
Cardiology is provided by the medical staff of the Cardiology Intensive Care Unit (emergency
medical team - EMT).
Our aim is to evolve a continuous quality improvement program with the usage of ZOLL R
Series defibrillator device and defibrillator pads with a real-time CPR feedback option and
CodeReview case analysis software, and to provide further execution of the program
thereafter.
In a prospective, non-randomized study, all of the basic and advanced cardiopulmonary
resuscitations would be analyzed. All resuscitation are planned to be performed by the above
mentioned devices according to the recent protocols. The continuous audio-visual feedback
and all the data obtained during the resuscitation are intended to develop a better CPR
training program in the future.
The downloading of data is planned to occur on the same day of CPR to a data card. After
approximately one week all the participant medical persons would receive a detailed case
analysis. Elimination of the typical errors is targeted.
Monitored quality indicators
Follow-up of CPR protocol:
elapsed time between turning on device and first chest compression elapsed time between
turning on device and first delivered shock elapsed time between turning on device and first
delivered shock in case of shockable rhythm compliance with 2 minutes long CPR period
recognition of rhythm, recognition of adequate therapy, follow-up of the protocol concernig
DC-shock recording the exact moment of the following procedures (with the use of Code Marker
button on the defibrillatior device) endotracheal intubation drug therapy obtaining
intravenous access oxygen therapy
Quality of chest compressions:
depth frequency release compression fraction
Discontinuance of chest compression - cause anf time interval (Code Marker) endotracheal
intubation ventilation rhythm analysis and defibrillation obtaining intravenous access
Other data (obtaining with manual recording):
cause of sudden cardiac death initial rhythm exact time of sudden death eyewitness records
data of the patient monitoring system (only optional) description of place participant of
CPR first detection medical documentation
Participant of the study:
Péter ANDRÉKA Prof. MD, Head of Department, Principal Investigator of study Gábor UZONYI MD,
Head of Intensive Care Unit Krisztina SZÜTS MD András CSEPREGI MD Attila KOVÁCS MD Péter
TAKÁCS MD András BECK MD Csaba SÁRI MD, Coordinator of study Adrienn MANDZÁK MD Judit
POLANECZKY Anna NAGYNÉ LŐKE
;
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