TY - JOUR
T1 - Integration of in-hospital cardiac arrest contextual curriculum into a basic life support course
T2 - a randomized, controlled simulation study
AU - Hunt, Elizabeth A.
AU - Duval-Arnould, Jordan M.
AU - Chime, Nnenna O.
AU - Jones, Kareen
AU - Rosen, Michael
AU - Hollingsworth, Merona
AU - Aksamit, Deborah
AU - Twilley, Marida
AU - Camacho, Cheryl
AU - Nogee, Daniel P.
AU - Jung, Julianna
AU - Nelson-McMillan, Kristen
AU - Shilkofski, Nicole
AU - Perretta, Julianne S.
N1 - Publisher Copyright:
© 2017
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Objective The objective was to compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). Design This study is a prospective, randomized, controlled curriculum evaluation. Setting Johns Hopkins Medicine Simulation Center. Subjects One hundred twenty-two first year medical students were divided into fifty-nine teams. Intervention HospBLS course of identical length, containing additional content contextual to hospital environments, taught utilizing Rapid Cycle Deliberate Practice (RCDP). Measurements The primary outcome measure during simulated cardiac arrest scenarios was chest compression fraction (CCF) and secondary outcome measures included metrics of high quality resuscitation. Main results Out-of-hospital cardiac arrest HospBLS teams had larger CCF: [69% (65–74) vs. 58% (53–62), p < 0.001] and were faster than TradBLS at initiating compressions: [median (IQR): 9 s (7–12) vs. 22 s (17.5–30.5), p < 0.001]. In-hospital cardiac arrest HospBLS teams had larger CCF: [73% (68–75) vs. 50% (43–54), p < 0.001] and were faster to initiate compressions: [10 s (6–11) vs. 36 s (27–63), p < 0.001]. All teams utilized the hospital AED to defibrillate within 180 s per AHA guidelines [HospBLS: 122 s (103–149) vs. TradBLS: 139 s (117–172), p = 0.09]. HospBLS teams performed more hospital-specific maneuvers to optimize compressions, i.e. utilized: CPR button to flatten bed: [7/30 (23%) vs. 0/29 (0%), p = 0.006], backboard: [21/30 (70%) vs. 5/29 (17%), p < 0.001], stepstool: [28/30 (93%) vs. 8/29 (28%), p < 0.001], lowered bedrails: [28/30 (93%) vs. 10/29 (34%), p < 0.001], connected oxygen appropriately: [26/30 (87%) vs. 1/29 (3%), p < 0.001] and used oral airway and/or two-person bagging when traditional bag-mask-ventilation unsuccessful: [30/30 (100%) vs. 0/29 (0%), p < 0.001]. Conclusion A hospital focused BLS course utilizing RCDP was associated with improved performance on hospital-specific quality measures compared with the traditional AHA course.
AB - Objective The objective was to compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). Design This study is a prospective, randomized, controlled curriculum evaluation. Setting Johns Hopkins Medicine Simulation Center. Subjects One hundred twenty-two first year medical students were divided into fifty-nine teams. Intervention HospBLS course of identical length, containing additional content contextual to hospital environments, taught utilizing Rapid Cycle Deliberate Practice (RCDP). Measurements The primary outcome measure during simulated cardiac arrest scenarios was chest compression fraction (CCF) and secondary outcome measures included metrics of high quality resuscitation. Main results Out-of-hospital cardiac arrest HospBLS teams had larger CCF: [69% (65–74) vs. 58% (53–62), p < 0.001] and were faster than TradBLS at initiating compressions: [median (IQR): 9 s (7–12) vs. 22 s (17.5–30.5), p < 0.001]. In-hospital cardiac arrest HospBLS teams had larger CCF: [73% (68–75) vs. 50% (43–54), p < 0.001] and were faster to initiate compressions: [10 s (6–11) vs. 36 s (27–63), p < 0.001]. All teams utilized the hospital AED to defibrillate within 180 s per AHA guidelines [HospBLS: 122 s (103–149) vs. TradBLS: 139 s (117–172), p = 0.09]. HospBLS teams performed more hospital-specific maneuvers to optimize compressions, i.e. utilized: CPR button to flatten bed: [7/30 (23%) vs. 0/29 (0%), p = 0.006], backboard: [21/30 (70%) vs. 5/29 (17%), p < 0.001], stepstool: [28/30 (93%) vs. 8/29 (28%), p < 0.001], lowered bedrails: [28/30 (93%) vs. 10/29 (34%), p < 0.001], connected oxygen appropriately: [26/30 (87%) vs. 1/29 (3%), p < 0.001] and used oral airway and/or two-person bagging when traditional bag-mask-ventilation unsuccessful: [30/30 (100%) vs. 0/29 (0%), p < 0.001]. Conclusion A hospital focused BLS course utilizing RCDP was associated with improved performance on hospital-specific quality measures compared with the traditional AHA course.
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Education
KW - Simulation
KW - Teamwork
KW - Time sensitive
UR - http://www.scopus.com/inward/record.url?scp=85016149338&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016149338&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2017.03.014
DO - 10.1016/j.resuscitation.2017.03.014
M3 - Article
C2 - 28323084
AN - SCOPUS:85016149338
SN - 0300-9572
VL - 114
SP - 127
EP - 132
JO - Resuscitation
JF - Resuscitation
ER -