Telemedical Intensivist Consultation During In-Hospital Cardiac Arrest Resuscitation

Relationship Between Resuscitation Team Members’ Self-Efficacy and Team Competence During In-Hospital Cardiac Arrest

“…After simulation completion, each participant was invited to complete a survey (7–9) evaluating contributors to resuscitation self-efficacy ( Appendix 1 , http://links.lww.com/CCX/B291). Respondents provided demographic data and ranked their agreement with each of three statements on a 5-point Likert-style scale: 1) “I felt confident in my role on the Code Blue team,” 2) “I had difficulty thinking clearly,” and 3) “I worry that I made errors.” The primary exposure was participant confidence in their resuscitation team role (“agree” or “strongly agree” response to the corresponding survey question).…”

“…We performed a secondary analysis of a randomized controlled trial (ClinicalTrials.gov NCT03000829) that investigated the impact of telemedicine consultation on resuscitation quality ( 7 ). The trial conducted high-fidelity in situ cardiac resuscitation simulations at seven Utah hospitals (one level 1 trauma hospital, two regional referral hospitals, three community hospitals, and a surgical specialty hospital) in 2017–2018.…”

“…IHCA simulation and data collection details have been previously described ( 7 ). In brief, simulations occurred in inpatient rooms on inpatient wards employing a SimMan 3G (Laerdaal, Stavanger, Norway) simulation mannequin and 11 unique clinical scenarios superimposed on an underlying three-phase simulation structure.…”

Tough Decisions in Resuscitation

“…8 Can copilots and innovative technology help with that complexity, perhaps by more focused processing of those iterative cycles? Peltan et al 6 research cannot answer that question, particularly because the simulations were short and did not focus on this aspect of the collaboration. Further research in the area will, hopefully, provide that focus and guide future systems developments.…”

“…These include public awareness and CPR training programs, resuscitation champions, widespread availability of defibrillators, rapid alerting and response systems, and, increasingly, the use of technologies that bring together the right resources within the right timeframe. 4,5 This edition of CHEST publishes a high-quality simulation study by Peltan et al 6 on the impact of such innovation on in-hospital cardiac arrest. In their study, the researchers tested the impact of a remote, expert "copilot" (an experienced critical care physician) on the quality of resuscitation provided by ad hoc hospital resuscitation teams, in a range of complex cardiac arrest simulations.…”