“Putting It All Together” to Improve Resuscitation Quality - 21/11/11

Doi : 10.1016/j.emc.2011.09.001

Robert M. Sutton, MD, MSCE ^a,^⁎ , Vinay Nadkarni, MD, MS ^a, Benjamin S. Abella, MD, MPhil ^b
^a Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania and the Children’s Hospital of Philadelphia, 7th Floor Central Wing: 7C09, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA
^b Department of Emergency Medicine, Center for Resuscitation Science, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA

Corresponding author.

Résumé

Solutions to improve care provided during cardiac arrest resuscitation attempts must be multifaceted and targeted to the diverse number of care providers to be successful. In this article, new approaches to improving cardiac arrest resuscitation performance are reviewed. The focus is on a continuous quality improvement paradigm highlighting improving training methods before actual cardiac arrest events, monitoring quality during resuscitation attempts, and using quantitative debriefing programs after events to educate frontline care providers.

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Keywords : Cardiopulmonary resuscitation, Cardiac arrest, Feedback, Debriefing

Plan

Current state of resuscitation performance

Improving performance improves outcomes

Before: resuscitation training

During: monitoring CPR quality with titration to patient physiology

Real-time Audiovisual Feedback

Arterial Blood Pressure and End-tidal CO₂

Matching Cardiac Arrest Physiology to Resuscitation

Mechanical CPR Devices

After: performance debriefing

Evidence that putting it all together improves outcomes

Summary

Financial Disclosures or Conflicts of Interest: Vinay Nadkarni receives unrestricted research grant support from the Laerdal Foundation for Acute Care Medicine. Robert Sutton is supported through a career development award from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (K23HD062629). Benjamin Abella receives research funding from Philips Healthcare, the American Heart Association, and the Doris Duke Foundation, and has received speaking honoraria from Philips Healthcare.