Inhospital cardiac arrest - the crucial first 5 min: a simulation study

Mathilde Stærk; Kasper Glerup Lauridsen; Camilla Thomsen Støtt; Dung Nguyen Riis; Bo Løfgren; Kristian Krogh

doi:10.1186/s41077-022-00225-0

Inhospital cardiac arrest - the crucial first 5 min: a simulation study

Mathilde Stærk, Kasper Glerup Lauridsen, Camilla Thomsen Støtt, Dung Nguyen Riis, Bo Løfgren, Kristian Krogh

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

7 Citations (Scopus)

Abstract

BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts.

METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings.

RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators.

CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.

Original language	English
Article number	29
Journal	Advances in Simulation
Volume	7
Issue	1
ISSN	2059-0628
DOIs	https://doi.org/10.1186/s41077-022-00225-0
Publication status	Published - Sept 2022

Keywords

Basic life support
In situ simulation
Inhospital cardiac arrest

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10.1186/s41077-022-00225-0Licence: CC BY

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title = "Inhospital cardiac arrest - the crucial first 5 min: a simulation study",

abstract = "BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts.METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings.RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators.CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.",

keywords = "Basic life support, In situ simulation, Inhospital cardiac arrest",

author = "Mathilde St{\ae}rk and {Glerup Lauridsen}, Kasper and St{\o}tt, {Camilla Thomsen} and Riis, {Dung Nguyen} and Bo L{\o}fgren and Kristian Krogh",

note = "{\textcopyright} 2022. The Author(s).",

year = "2022",

month = sep,

doi = "10.1186/s41077-022-00225-0",

language = "English",

volume = "7",

journal = "Advances in Simulation",

issn = "2059-0628",

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T1 - Inhospital cardiac arrest - the crucial first 5 min

T2 - a simulation study

AU - Stærk, Mathilde

AU - Glerup Lauridsen, Kasper

AU - Støtt, Camilla Thomsen

AU - Riis, Dung Nguyen

AU - Løfgren, Bo

AU - Krogh, Kristian

PY - 2022/9

Y1 - 2022/9

N2 - BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts.METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings.RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators.CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.

AB - BACKGROUND: Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts.METHODS: We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings.RESULTS: We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators.CONCLUSION: Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.

KW - Basic life support

KW - In situ simulation

KW - Inhospital cardiac arrest

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U2 - 10.1186/s41077-022-00225-0

DO - 10.1186/s41077-022-00225-0

M3 - Journal article

C2 - 36085089

SN - 2059-0628

VL - 7

JO - Advances in Simulation

JF - Advances in Simulation

IS - 1

M1 - 29

ER -

Inhospital cardiac arrest - the crucial first 5 min: a simulation study

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Keywords

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