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The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest

Background The Resuscitation Rotation is a novel second-year emergency medicine rotation focusing on the highest acuity patients, including out-of-hospital cardiac arrest (OHCA). The resuscitation resident (RR) functions as an extra physician during resuscitation and post return of spontaneous circu...

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Autores principales: Wloszczynski, Patrick, Berger, David A, Lee, David M, Chen, Nai-Wei, Burla, Michael J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710492/
https://www.ncbi.nlm.nih.gov/pubmed/36465226
http://dx.doi.org/10.7759/cureus.32050
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author Wloszczynski, Patrick
Berger, David A
Lee, David M
Chen, Nai-Wei
Burla, Michael J
author_facet Wloszczynski, Patrick
Berger, David A
Lee, David M
Chen, Nai-Wei
Burla, Michael J
author_sort Wloszczynski, Patrick
collection PubMed
description Background The Resuscitation Rotation is a novel second-year emergency medicine rotation focusing on the highest acuity patients, including out-of-hospital cardiac arrest (OHCA). The resuscitation resident (RR) functions as an extra physician during resuscitation and post return of spontaneous circulation (ROSC). The objective of this study is to examine if the presence of a RR decreases the pre-induction interval of targeted temperature management (TTM) for patients following OHCA. Methods A retrospective study was conducted at a tertiary care level 1 trauma center with an annual ED census of 127,323 visits in 2019. We retrospectively reviewed consecutive OHCA patients from September 1, 2014, to July 20, 2020, who underwent TTM. Patients were identified as cases with or without a RR. Clinical characteristics were summarized by the status of RR involvement and compared by using t-test and χ(2) test for continuous and categorical variables, respectively. All tests with p < 0.05 were considered to indicate statistical significance. Results Our study population identified 198 adult OHCA patients that underwent TTM from 2014-2020. There were exclusions for missing TTM start time and for missing patient characteristics leaving 176 for final analysis, of which 55 (33.3%) had RR involvement. The mean time (hours) to TTM initiation (ie, the pre-induction phase) for patients involving the RR versus those without was not statistically significant (3.11 vs 3.34, p=0.39). Linear regression analysis indicates that the adjusted effect of RR involvement was not associated with the mean hours of pre-induction (p=0.47). Conclusion There is no statistically significant association of a RR on the duration of the pre-induction phase. Limitations include that both arms had prolonged pre-induction phases. This may represent a non-optimized TTM protocol. Future work will aim to use the RR to improve our pre-induction phase.
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spelling pubmed-97104922022-12-01 The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Wloszczynski, Patrick Berger, David A Lee, David M Chen, Nai-Wei Burla, Michael J Cureus Cardiology Background The Resuscitation Rotation is a novel second-year emergency medicine rotation focusing on the highest acuity patients, including out-of-hospital cardiac arrest (OHCA). The resuscitation resident (RR) functions as an extra physician during resuscitation and post return of spontaneous circulation (ROSC). The objective of this study is to examine if the presence of a RR decreases the pre-induction interval of targeted temperature management (TTM) for patients following OHCA. Methods A retrospective study was conducted at a tertiary care level 1 trauma center with an annual ED census of 127,323 visits in 2019. We retrospectively reviewed consecutive OHCA patients from September 1, 2014, to July 20, 2020, who underwent TTM. Patients were identified as cases with or without a RR. Clinical characteristics were summarized by the status of RR involvement and compared by using t-test and χ(2) test for continuous and categorical variables, respectively. All tests with p < 0.05 were considered to indicate statistical significance. Results Our study population identified 198 adult OHCA patients that underwent TTM from 2014-2020. There were exclusions for missing TTM start time and for missing patient characteristics leaving 176 for final analysis, of which 55 (33.3%) had RR involvement. The mean time (hours) to TTM initiation (ie, the pre-induction phase) for patients involving the RR versus those without was not statistically significant (3.11 vs 3.34, p=0.39). Linear regression analysis indicates that the adjusted effect of RR involvement was not associated with the mean hours of pre-induction (p=0.47). Conclusion There is no statistically significant association of a RR on the duration of the pre-induction phase. Limitations include that both arms had prolonged pre-induction phases. This may represent a non-optimized TTM protocol. Future work will aim to use the RR to improve our pre-induction phase. Cureus 2022-11-30 /pmc/articles/PMC9710492/ /pubmed/36465226 http://dx.doi.org/10.7759/cureus.32050 Text en Copyright © 2022, Wloszczynski et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Wloszczynski, Patrick
Berger, David A
Lee, David M
Chen, Nai-Wei
Burla, Michael J
The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title_full The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title_fullStr The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title_full_unstemmed The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title_short The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
title_sort effect of resuscitation residents on the duration of pre-induction of targeted temperature management in out-of-hospital cardiac arrest
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710492/
https://www.ncbi.nlm.nih.gov/pubmed/36465226
http://dx.doi.org/10.7759/cureus.32050
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