Factors associated with delayed defibrillation in cardiopulmonary resuscitation: A prospective simulation study
| Autor: | Nora Celebi, Alexander Münch, Leopold Haffner, Moritz Mahling, Jörg Reutershan, Christoph Castan, Jan Griewatz, Anne Hermann-Werner, Reimer Riessen |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Critical Care and Emergency Medicine medicine.medical_treatment Ambulances Social Sciences lcsh:Medicine Transportation 030204 cardiovascular system & hematology Electrocardiography 0302 clinical medicine Sociology Interquartile range Medicine and Health Sciences Cardiac Arrest Prospective Studies Prospective cohort study lcsh:Science Multidisciplinary medicine.diagnostic_test Hospitals Bioassays and Physiological Analysis Ventricular Fibrillation Lectures Engineering and Technology Female Medical emergency Research Article Adult Defibrillation Resuscitation Cardiology Equipment Research and Analysis Methods Education 03 medical and health sciences medicine Humans Cardiopulmonary resuscitation business.industry Electrophysiological Techniques lcsh:R Basic life support 030208 emergency & critical care medicine medicine.disease Cardiopulmonary Resuscitation Heart Arrest Health Care Health Care Facilities Ventricular fibrillation Airway management lcsh:Q Cardiac Electrophysiology business Defibrillators |
| Zdroj: | PLoS ONE, Vol 12, Iss 6, p e0178794 (2017) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Introduction Early defibrillation is an important factor of survival in cardiac arrest. However, novice resuscitators often struggle with cardiac arrest patients. We investigated factors leading to delayed defibrillation performed by final-year medical students within a simulated bystander cardiac arrest situation. Methods Final-year medical students received a refresher lecture and basic life support training before being confronted with a simulated cardiac arrest situation in a simulation ambulance. The scenario was analyzed for factors leading to delayed defibrillation. We compared the time intervals the participants needed for various measures with a benchmark set by experienced resuscitators. After training, the participants were interviewed regarding challenges and thoughts during the scenario. Results The median time needed for defibrillation was 158 s (n = 49, interquartile range: 107-270 s), more than six-fold of the benchmark time. The major part of total defibrillation time (49%; median, n = 49) was between onset of ventricular fibrillation and beginning to prepare the defibrillator, more specifically the time between end of preparation of the defibrillator and actual delivery of the shock, with a mean proportion of 26% (n = 49, SD = 17%) of the overall time needed for defibrillation (maximum 67%). Self-reported reasons for this delay included uncertainty about the next step to take, as reported by 73% of the participants. A total of 35% were unsure about which algorithm to follow. Diagnosing the patient was subjectively difficult for 35% of the participants. Overall, 53% of the participants felt generally confused. Conclusions Our study shows that novice resuscitators rarely achieve guideline-recommended defibrillation times. The most relative delays were observed when participants had to choose what to do next or which algorithm to follow, and thus i.e. performed extensive airway management before a life-saving defibrillation. Our data provides a first insight in the process of defibrillation delay and can be used to generate new hypotheses on how to provide a timely defibrillation. |
| Databáze: | OpenAIRE |
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