How is quality of cardiopulmonary resuscitation being assessed? A national survey of Canadian emergency medicine physicians

Abstract

BackgroundHigh-quality cardiopulmonary resuscitation (CPR) is a fundamental intervention for cardiac arrest, yet health care providers rarely adhere to recommended guidelines. Real-time feedback improves CPR performance. It is currently unknown how Canadian emergency physicians assess CPR quality during cardiac arrest and if they use feedback devices. Our aim was to describe how emergency physicians assess CPR quality and to describe eventual barriers to implementation of feedback technology.MethodsThis was a cross-sectional survey that was distributed to attending and resident emergency physicians through the Canadian Association of Emergency Physicians. Responses were summarized and analyzed using descriptive statistics.ResultsThe response rate was 19% (323/1735). Visual observation was the most common method of assessing CPR quality (41.2%), with leaders standing at the foot of the bed (67.4%). This was followed by real-time pulse check (29.7%) and end-tidal CO2 values (21.7%). Only 12% of physicians utilized CPR feedback technology. The most common perceived barrier to utilization was unavailability, inexperience with devices and lack of guidelines/evidence for their use.ConclusionMost Canadian emergency physicians that responded to our survey, assess quality of CPR by standing at the foot of the bed and utilize visual observation and palpation methods which are known to be inaccurate. A minority utilize objective measurements such as ETCO2 or feedback devices, with the greatest barrier being lack of availability.

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Monitoring Cardiopulmonary Resuscitation Quality in Emergency Department: A National Survey in China on Current Knowledge, Attitudes, and Practices

“…Continuing education of physicians in emergency departments was crucial to increase the rates of utilization of recommended technology [22] . Although CPR quality monitoring has been recommended by CPR guidelines, few speci c consensus protocols exist that provide detail on how to best implement the monitoring.…”