Developing a Checklist for Cardiopulmonary Resuscitation (CPR) Quality Control in Emergency Department; a Qualitative Study
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
1 January 2019
,
Page e61
https://doi.org/10.22037/aaem.v7i1.456
Abstract
Introduction: Monitoring the quality of cardiopulmonary resuscitation (CPR) could help in achieving favorable outcomes, decreasing mortality, and preventing post-CPR neurologic sequels. This study aimed to generate a user-friendly checklist for CPR quality control in emergency department (ED).
Method: A qualitative study was performed between January and December 2018. In the first step, two emergency medicine specialists searched currently available databases and extracted the factors related to CPR quality. Afterward, two sessions of focus group discussions were held. The participants included four emergency medicine specialists, two ED managers, one anesthesiologist, and one cardiologist. Subsequently, 20 medical specialists, consisting of 10 emergency medicine specialists, six anesthesiologists, and four cardiologists, were invited to a Delphi panel in order to rate the extracted items from the prior group discussions.
Results: During the two rounds of focus group discussions, 38 items related to the quality of CPR were identified. A Delphi panel evaluated the items; 31 items with at least 75% agreement were selected. These 31 items were included in the final checklist and after a pilot study and adjustment of its content they were sorted in 10 categories as follows: 1. chest compression, 2. airway, 3. bag-mask ventilation, 4. cardiac monitoring, 5. defibrillation, 6. intravenous (IV) drug delivery, 7. Medications, 8. Advanced airway, 9. CPR sequence, and 10. Reversible causes.
Conclusion: Our study provides a checklist for monitoring the quality of CPR in ED, but it is still necessary to include other factors related to the ED environment on this checklist.
- Cardiopulmonary Resuscitation
- Heart arrest
- quality control
- Emergency Medicine
How to Cite
References
Crowe C, Bobrow BJ, Vadeboncoeur TF, Dameff C, Stolz U, Silver A, et al. Measuring and improving cardiopulmonary resuscitation quality inside the emergency department. Resuscitation. 2015;93:8-13.
Losert H, Sterz F, Köhler K, Sodeck G, Fleischhackl R, Eisenburger P, et al. Quality of cardiopulmonary resuscitation among highly trained staff in an emergency department setting. Archives of internal medicine. 2006;166(21):2375-80.
Meaney PA, Bobrow BJ, Mancini ME, Christenson J, De Caen AR, Bhanji F, et al. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013;128(4):417-35.
Talikowska M, Tohira H, Finn J. Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: a systematic review and meta-analysis. Resuscitation. 2015;96:66-77.
Wallace SK, Abella BS, Becker LB. Quantifying the effect of cardiopulmonary resuscitation quality on cardiac arrest outcome: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes. 2013;6(2):148-56.
Farahmand S, Karimialavijeh E, Vahedi HSM, Jahanshir A. Emergency medicine as a growing career in Iran: an Internet-based survey. World journal of emergency medicine. 2016;7(3):196.
McEvoy MD, Smalley JC, Nietert PJ, Field LC, Furse CM, Blenko JW, et al. Validation of a detailed scoring checklist for use during advanced cardiac life support certification. Simulation in healthcare: journal of the Society for Simulation in Healthcare. 2012;7(4):222.
Idris AH, Guffey D, Aufderheide TP, Brown S, Morrison LJ, Nichols P, et al. Relationship between chest compression rates and outcomes from cardiac arrest. Circulation. 2012;125(24):3004-12.
Idris AH, Guffey D, Pepe PE, Brown SP, Brooks SC, Callaway CW, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Critical care medicine. 2015;43(4):840-8.
Cheskes S, Schmicker RH, Verbeek PR, Salcido DD, Brown SP, Brooks S, et al. The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial. Resuscitation. 2014;85(3):336-42.
Sutton RM, French B, Niles DE, Donoghue A, Topjian AA, Nishisaki A, et al. 2010 American Heart Association recommended compression depths during pediatric in-hospital resuscitations are associated with survival. Resuscitation. 2014;85(9):1179-84.
Stiell IG, Brown SP, Christenson J, Cheskes S, Nichol G, Powell J, et al. What is the role of chest compression depth during out-of-hospital cardiac arrest resuscitation? Critical care medicine. 2012;40(4):1192.
Yu BG, Oh JH, Kim Y, Kim TW. Accurate measurement of chest compression depth using impulse-radio ultra-wideband sensor on a mattress. PloS one. 2017;12(8):e0183971.
Cha WC, Lee EJ, Hwang S-s. The duration of cardiopulmonary resuscitation in emergency departments after out-of-hospital cardiac arrest is associated with the outcome: a nationwide observational study. Resuscitation. 2015;96:323-7.
Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, et al. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015;86:88-94.
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