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The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study

Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physic...

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Autores principales: Sellmann, Timur, Oendorf, Andrea, Wetzchewald, Dietmar, Schwager, Heidrun, Thal, Serge Christian, Marsch, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180995/
https://www.ncbi.nlm.nih.gov/pubmed/35683550
http://dx.doi.org/10.3390/jcm11113163
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author Sellmann, Timur
Oendorf, Andrea
Wetzchewald, Dietmar
Schwager, Heidrun
Thal, Serge Christian
Marsch, Stephan
author_facet Sellmann, Timur
Oendorf, Andrea
Wetzchewald, Dietmar
Schwager, Heidrun
Thal, Serge Christian
Marsch, Stephan
author_sort Sellmann, Timur
collection PubMed
description Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined by the team or tutor or left open). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not affect hands-on time (91% [87–93] vs. 92% [88–94] for “withdrawn” and 92 [88–93] for “agitated” relatives; p = 0.15). The teams interacted significantly less with a “withdrawn” than with an “agitated” relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an “agitated” relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all <0.05 compared to control); in addition, an “agitated” relative increased mental demands and total task load (both p < 0.05 compared to “withdrawn” and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an “agitated” relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761).
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spelling pubmed-91809952022-06-10 The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study Sellmann, Timur Oendorf, Andrea Wetzchewald, Dietmar Schwager, Heidrun Thal, Serge Christian Marsch, Stephan J Clin Med Article Background: Guidelines recommend that relatives be present during cardiopulmonary resuscitation (CPR). This randomised trial investigated the effects of two different behaviour patterns of relatives on rescuers’ perceived stress and quality of CPR. Material and methods: Teams of three to four physicians were randomised to perform CPR in the presence of no relatives (control group), a withdrawn relative, or an agitated relative, played by actors according to a scripted role, and to three different models of leadership (randomly determined by the team or tutor or left open). The scenarios were video-recorded. Hands-on time was primary, and the secondary outcomes comprised compliance to CPR algorithms, perceived workload, and the influence of leadership. Results: 1229 physicians randomised to 366 teams took part. The presence of a relative did not affect hands-on time (91% [87–93] vs. 92% [88–94] for “withdrawn” and 92 [88–93] for “agitated” relatives; p = 0.15). The teams interacted significantly less with a “withdrawn” than with an “agitated” relative (11 [7–16]% vs. 23 [15–30]% of the time spent for resuscitation, p < 0.01). The teams confronted with an “agitated” relative showed more unsafe defibrillations, higher ventilation rates, and a delay in starting CPR (all p < 0.05 vs. control). The presence of a relative increased frustration, effort, and perceived temporal demands (all <0.05 compared to control); in addition, an “agitated” relative increased mental demands and total task load (both p < 0.05 compared to “withdrawn” and control group). The type of leadership condition did not show any effects. Conclusions: Interaction with a relative accounted for up to 25% of resuscitation time. Whereas the presence of a relative per se increased the task load in different domains, only the presence of an “agitated” relative had a marginal detrimental effect on CPR quality (GERMAN study registers number DRKS00024761). MDPI 2022-06-02 /pmc/articles/PMC9180995/ /pubmed/35683550 http://dx.doi.org/10.3390/jcm11113163 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sellmann, Timur
Oendorf, Andrea
Wetzchewald, Dietmar
Schwager, Heidrun
Thal, Serge Christian
Marsch, Stephan
The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title_full The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title_fullStr The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title_full_unstemmed The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title_short The Impact of Withdrawn vs. Agitated Relatives during Resuscitation on Team Workload: A Single-Center Randomised Simulation-Based Study
title_sort impact of withdrawn vs. agitated relatives during resuscitation on team workload: a single-center randomised simulation-based study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180995/
https://www.ncbi.nlm.nih.gov/pubmed/35683550
http://dx.doi.org/10.3390/jcm11113163
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