Abstract
Aim: Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. Methods: Modified Delphi consensus process to design standardised communication elements. Feasibility was pilot tested in 16 simulated CPR scenarios (8 scenarios with physician team leaders and 8 with chest compressors) randomized (1:1) to standardised [INTERVENTION] vs. closed-loop communication [CONTROL]. Adherence and efficacy (duration of CC pauses for defibrillation, intubation, rhythm check) was assessed by audiovisual recording. Mental demand and frustration were assessed by NASA task load index subscales. Results: Consensus elements for standardised communication included: 1) team preparation 15−30 s before CC interruption, 2) pre-interruption countdown synchronized with last 5 CCs, 3) specific action words for defibrillation, intubation, and interrupting/resuming CCs. Median (Q1,Q3) adherence to standardised phrases was 98% (80%,100%). Efficacy analysis showed a median [Q1,Q3] peri-shock pause of 5.1 s. [4.4; 5.8] vs. 7.5 s. [6.3; 8.8] seconds, p < 0.001, intubation pause of 3.8 s. [3.6; 5.0] vs. 6.9 s. [4.8; 10.1] seconds, p = 0.03, rhythm check pause of 4.2 [3.2,5.7] vs. 8.6 [5.0,10.5] seconds, p < 0.001, median frustration index of 10/100 [5,20] vs. 35/100 [25,50], p < 0.001, and median mental demand load of 55/100 [30,70] vs. 65/100 [50,85], p = 0.41 for standardised vs. closed loop communication. Conclusion: This pilot study demonstrated feasibility of using consensus-based standardised communication that was associated with shorter CC pauses for defibrillation, intubation, and rhythm checks without increasing frustration index or mental demand compared to current best practice, closed loop communication.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 73-80 |
| Number of pages | 8 |
| Journal | Resuscitation |
| Volume | 147 |
| DOIs | |
| State | Published - Feb 1 2020 |
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Keywords
- Advanced life support
- Communication
- Delphi technique
- In-hospital cardiac arrest
- Nontechnical skills
- Simulation
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
- Cardiology and Cardiovascular Medicine
Cite this
Standardising communication to improve in-hospital cardiopulmonary resuscitation. / Lauridsen, Kasper Glerup; Watanabe, Ichiro; Løfgren, Bo; Cheng, Adam; Duval-Arnould, Jordan; Hunt, Elizabeth A.; Good, Grace L.; Niles, Dana; Berg, Robert A.; Nishisaki, Akira; Nadkarni, Vinay M.
In: Resuscitation, Vol. 147, 01.02.2020, p. 73-80.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Standardising communication to improve in-hospital cardiopulmonary resuscitation
AU - Lauridsen, Kasper Glerup
AU - Watanabe, Ichiro
AU - Løfgren, Bo
AU - Cheng, Adam
AU - Duval-Arnould, Jordan
AU - Hunt, Elizabeth A.
AU - Good, Grace L.
AU - Niles, Dana
AU - Berg, Robert A.
AU - Nishisaki, Akira
AU - Nadkarni, Vinay M.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Aim: Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. Methods: Modified Delphi consensus process to design standardised communication elements. Feasibility was pilot tested in 16 simulated CPR scenarios (8 scenarios with physician team leaders and 8 with chest compressors) randomized (1:1) to standardised [INTERVENTION] vs. closed-loop communication [CONTROL]. Adherence and efficacy (duration of CC pauses for defibrillation, intubation, rhythm check) was assessed by audiovisual recording. Mental demand and frustration were assessed by NASA task load index subscales. Results: Consensus elements for standardised communication included: 1) team preparation 15−30 s before CC interruption, 2) pre-interruption countdown synchronized with last 5 CCs, 3) specific action words for defibrillation, intubation, and interrupting/resuming CCs. Median (Q1,Q3) adherence to standardised phrases was 98% (80%,100%). Efficacy analysis showed a median [Q1,Q3] peri-shock pause of 5.1 s. [4.4; 5.8] vs. 7.5 s. [6.3; 8.8] seconds, p < 0.001, intubation pause of 3.8 s. [3.6; 5.0] vs. 6.9 s. [4.8; 10.1] seconds, p = 0.03, rhythm check pause of 4.2 [3.2,5.7] vs. 8.6 [5.0,10.5] seconds, p < 0.001, median frustration index of 10/100 [5,20] vs. 35/100 [25,50], p < 0.001, and median mental demand load of 55/100 [30,70] vs. 65/100 [50,85], p = 0.41 for standardised vs. closed loop communication. Conclusion: This pilot study demonstrated feasibility of using consensus-based standardised communication that was associated with shorter CC pauses for defibrillation, intubation, and rhythm checks without increasing frustration index or mental demand compared to current best practice, closed loop communication.
AB - Aim: Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. Methods: Modified Delphi consensus process to design standardised communication elements. Feasibility was pilot tested in 16 simulated CPR scenarios (8 scenarios with physician team leaders and 8 with chest compressors) randomized (1:1) to standardised [INTERVENTION] vs. closed-loop communication [CONTROL]. Adherence and efficacy (duration of CC pauses for defibrillation, intubation, rhythm check) was assessed by audiovisual recording. Mental demand and frustration were assessed by NASA task load index subscales. Results: Consensus elements for standardised communication included: 1) team preparation 15−30 s before CC interruption, 2) pre-interruption countdown synchronized with last 5 CCs, 3) specific action words for defibrillation, intubation, and interrupting/resuming CCs. Median (Q1,Q3) adherence to standardised phrases was 98% (80%,100%). Efficacy analysis showed a median [Q1,Q3] peri-shock pause of 5.1 s. [4.4; 5.8] vs. 7.5 s. [6.3; 8.8] seconds, p < 0.001, intubation pause of 3.8 s. [3.6; 5.0] vs. 6.9 s. [4.8; 10.1] seconds, p = 0.03, rhythm check pause of 4.2 [3.2,5.7] vs. 8.6 [5.0,10.5] seconds, p < 0.001, median frustration index of 10/100 [5,20] vs. 35/100 [25,50], p < 0.001, and median mental demand load of 55/100 [30,70] vs. 65/100 [50,85], p = 0.41 for standardised vs. closed loop communication. Conclusion: This pilot study demonstrated feasibility of using consensus-based standardised communication that was associated with shorter CC pauses for defibrillation, intubation, and rhythm checks without increasing frustration index or mental demand compared to current best practice, closed loop communication.
KW - Advanced life support
KW - Communication
KW - Delphi technique
KW - In-hospital cardiac arrest
KW - Nontechnical skills
KW - Simulation
UR - http://www.scopus.com/inward/record.url?scp=85077643966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077643966&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2019.12.013
DO - 10.1016/j.resuscitation.2019.12.013
M3 - Article
C2 - 31891790
AN - SCOPUS:85077643966
VL - 147
SP - 73
EP - 80
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -