Implementation of a Team-Focused High-Performance CPR (TF-HP-CPR) Protocol Within a Rural Area EMS System
| Autor: | Adam J McHone, Jason Edsall, Jennie Gunn, Everett Lineberry |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Emergency Medical Services
Quality management medicine.medical_treatment education Blind insertion airway device Emergency Nursing Return of spontaneous circulation 03 medical and health sciences 0302 clinical medicine Clinical Protocols Emergency medical services Humans Medicine 030212 general & internal medicine Cardiopulmonary resuscitation Patient Care Team Protocol (science) business.industry 030208 emergency & critical care medicine Small sample medicine.disease Cardiopulmonary Resuscitation Emergency Medicine Rural Health Services Medical emergency Rural area business |
| Zdroj: | Advanced Emergency Nursing Journal. 41:348-356 |
| ISSN: | 1931-4485 |
| Popis: | Team-focused, high-performance cardiopulmonary resuscitation (TF-HP-CPR) improves the return of spontaneous circulation (ROSC) among patients with out-of-hospital cardiac arrest (OHCA) events. In 2010, the American Heart Association began endorsing TF-HP-CPR (). A rural-area Virginia emergency medical services (EMS) system receives assistant medical oversight from an emergency nurse practitioner (ENP). The ENP is responsible for assisting the physician medical director in promoting continuous quality improvement (QI) within the EMS system. In January 2018, a QI project implemented a TF-HP-CPR protocol. The QI project encompassed the provision of education for EMS personnel about TF-HP-CPR with mock code evaluations. The protocol incorporated a newly designated blind insertion airway device and integrated the routine monitoring of end-tidal carbon dioxide (ETCO2) values. The QI project also introduced postresuscitation attempt report cards that were completed by the team leader at the conclusion of each CPR event. A random 16-week sample of patients with OHCA just before implementation of the QI project was analyzed and compared with patients who experienced an OHCA event within a 16-week period after implementation of the TF-HP-CPR protocol. The preimplementation group had 13 patients compared with 11 patients in the postimplementation group. The rate of ROSC in the preimplementation group was 38.46% compared with 54.55% in the postimplementation group. Although the rate of ROSC increased by 16.09%, the findings were not statistically significant (p = 0.6824) and were perceived to be likely due to the small sample sizes. The implementation of a TF-HP-CPR protocol improved the rate of ROSC among patients with OHCA; however, the findings were not statistically significant. A more extensive study is essential for further evaluation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|