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Inhospital cardiac arrest — the crucial first 5 min: a simulation study

BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inh...

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Autores principales: Stærk, Mathilde, Lauridsen, Kasper G., Støtt, Camilla Thomsen, Riis, Dung Nguyen, Løfgren, Bo, Krogh, Kristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462625/
https://www.ncbi.nlm.nih.gov/pubmed/36085089
http://dx.doi.org/10.1186/s41077-022-00225-0
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author Stærk, Mathilde
Lauridsen, Kasper G.
Støtt, Camilla Thomsen
Riis, Dung Nguyen
Løfgren, Bo
Krogh, Kristian
author_facet Stærk, Mathilde
Lauridsen, Kasper G.
Støtt, Camilla Thomsen
Riis, Dung Nguyen
Løfgren, Bo
Krogh, Kristian
author_sort Stærk, Mathilde
collection PubMed
description BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts. METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings. RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators. CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.
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spelling pubmed-94626252022-09-10 Inhospital cardiac arrest — the crucial first 5 min: a simulation study Stærk, Mathilde Lauridsen, Kasper G. Støtt, Camilla Thomsen Riis, Dung Nguyen Løfgren, Bo Krogh, Kristian Adv Simul (Lond) Research BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts. METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings. RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators. CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress. BioMed Central 2022-09-09 /pmc/articles/PMC9462625/ /pubmed/36085089 http://dx.doi.org/10.1186/s41077-022-00225-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Stærk, Mathilde
Lauridsen, Kasper G.
Støtt, Camilla Thomsen
Riis, Dung Nguyen
Løfgren, Bo
Krogh, Kristian
Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title_full Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title_fullStr Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title_full_unstemmed Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title_short Inhospital cardiac arrest — the crucial first 5 min: a simulation study
title_sort inhospital cardiac arrest — the crucial first 5 min: a simulation study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462625/
https://www.ncbi.nlm.nih.gov/pubmed/36085089
http://dx.doi.org/10.1186/s41077-022-00225-0
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