The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study

Cheng, Adam; Lin, Yiqun; Wan, Brandi; Duff, Jonathan P.; Brown, Linda; Bhanji, Farhan; Kessler, David; Tofil, Nancy M.; Hecker, Kent G.; Hunt, Elizabeth A.

doi:10.1017/cem.2017.12

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…With regard to the evaluation of BLS quality, there is evidence in the literature for the use of both the OOM and an EFM (Oermann et al, 2010;Partiprajak and Thongpo, 2016;Anderson et al, 2019;Cheng et al, 2018;Schmitz et al, 2020). We did not find a justification for the use of one over the other.…”

Section: Discussioncontrasting

confidence: 56%

“…Indeed, in a study by Oermann et al in 2010 evaluating different training methods for CPR, participants were evaluated using an electronic feedback method (EFM) (Oermann et al, 2010). Other authors have also used electronic feedback systems to evaluate CPR proficiency (Partiprajak and Thongpo, 2016;Anderson et al, 2019;Cheng et al, 2018). On the other hand, a study published in January 2020 by Schmitz et al relied on an observer only method (OOM) to evaluate the quality of CPR performance by emergency physicians (Schmitz et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Determining the equivalence of currently most used methods for evaluating cardiopulmonary resuscitation performance

Dhondt¹,

Verelst²,

Roosen³

et al. 2021

MedEdPublish

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Background High quality cardiopulmonary resuscitation (CPR) is imperative to obtain a better outcome after a sudden cardiac arrest. However, a gold standard for training and evaluating CPR performance is lacking. In our institution, we recently changed from an observer only method (OOM) to a combined observer and electronic feedback method (EFM). Objective To determine whether an OOM and an EFM for evaluating CPR performance are equivalent and therefore can be used interchangeably. Design We performed a retrospective analysis on test results of CPR performance of medical students. In 2016, an OOM was used to evaluate CPR performance whereas in 2017, an EFM was added. The evaluation of hand placement, rate and depth of compressions, adequacy of ventilations, overall compression and ventilation score by both methods was compared. Results

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Determining the equivalence of currently most used methods for evaluating cardiopulmonary resuscitation performance

Dhondt¹,

Verelst²,

Roosen³

et al. 2021

MedEdPublish

View full text Add to dashboard Cite

show abstract

“…These factors may predispose and/or increase the risk of injury during a resuscitation. In addition to prevention of musculoskeletal strain, a recent simulation study found the use of a step stool (23 cm in height) was associated with improved compression depth [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

Hospital resuscitation teams: a review of the risks to the healthcare worker

2017

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Background“Code blue” events and related resuscitation efforts involve multidisciplinary bedside teams that implement specialized interventions aimed at patient revival. Activities include performing effective chest compressions, assessing and restoring a perfusing cardiac rhythm, stabilizing the airway, and treating the underlying cause of the arrest. While the existing critical care literature has appropriately focused on the patient, there has been a dearth of information discussing the various stresses to the healthcare team. This review summarizes the available literature regarding occupational risks to medical emergency teams, characterizes these risks, offers preventive strategies to healthcare workers, and highlights further research needs.MethodsWe performed a literature search of PubMed for English articles of all types (randomized controlled trials, case-control and cohort studies, case reports and series, editorials and commentaries) through September 22, 2016, discussing potential occupational hazards during resuscitation scenarios. Of the 6266 articles reviewed, 73 relevant articles were included.ResultsThe literature search identified six potential occupational risk categories to members of the resuscitation team—infectious, electrical, musculoskeletal, chemical, irradiative, and psychological. Retrieved articles were reviewed in detail by the authors.ConclusionOverall, we found there is limited evidence detailing the risks to healthcare workers performing resuscitation. We identify these risks and offer potential solutions. There are clearly numerous opportunities for further study in this field.

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“…29–31 In addition, CPR quality is also influenced by factors other than training, such as the type of mattress on which the patient was put, 32 the use of backboard 33 and height of the CPR providers. 34 At present, it is not practical to account for all of these confounding factors in a trial-based economic evaluation. The cost-effectiveness conclusion of distributed practice relative to conventional training might also change, if taking the costs of post-arrest care into consideration.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

et al. 2020

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ContextAlthough distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR training.MethodsWe measured educational resource use, costs, and outcomes of both conventional training and distributed training groups in a prospective-randomised trial conducted with paediatric acute care providers over 12 months. Costs were calculated and reported from the perspective of the health institution. Incremental costs and effectiveness of distributed CPR training relative to conventional training were presented. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) if appropriate. One-way sensitivity analyses and probabilistic sensitivity analysis were conducted.ResultsA total of 87 of 101 enrolled participants completed the training (46/53 in intervention and 41/48 in the control). Compared with conventional training, the distributed CPR training group had a higher proportion of participants achieving CPR excellence, defined as over 90% guideline compliant for chest compression depth, rate and recoil (control: 0.146 (6/41) vs intervention 0.543 (25/46), incremental effectiveness: +0.397) with decreased costs (control: $C266.50 vs intervention $C224.88 per trainee, incremental costs: −$C41.62). The sensitivity analysis showed that when the institution does not pay for the training time, distributed CPR training results in an ICER of $C147.05 per extra excellent CPR provider.ConclusionWorkplace-based distributed CPR training with real-time feedback resulted in improved CPR quality by paediatric healthcare providers and decreased training costs, when training time is paid by the institution. If the institution does not pay for training time, implementing distributed training resulted in better CPR quality and increased costs, compared with conventional training. These findings contribute further evidence to the decision-making processes as to whether institutions/programmes should financially adopt these training programmes.

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The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study

Abstract: Step stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

Cited by 14 publications

References 30 publications

Determining the equivalence of currently most used methods for evaluating cardiopulmonary resuscitation performance

Determining the equivalence of currently most used methods for evaluating cardiopulmonary resuscitation performance

Hospital resuscitation teams: a review of the risks to the healthcare worker

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

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