open access

Vol 6, No 1 (2021)
Research paper
Published online: 2021-02-26
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Implementation of extended cardiopulmonary resuscitation procedure in in-hospital cardiac arrest: a preliminary simulated study

Maciej Sip, Mateusz Puslecki, Marek Dabrowski, Tomasz Klosiewicz, Marcin Ligowski, Sebastian Stefaniak, Lukasz Szarpak, Christopher Paprocki, Marek Jemielity, Bartlomiej Perek
DOI: 10.5603/DEMJ.a2021.0002
·
Disaster Emerg Med J 2021;6(1):10-20.

open access

Vol 6, No 1 (2021)
ORIGINAL ARTICLES
Published online: 2021-02-26

Abstract

INTRODUCTION: The survival rate of patients after in-hospital cardiac arrest (IHCA) is poor. The implementation of novel technologies to conventional cardio-pulmonary resuscitation (CPR) may improve clinical outcomes.   Aim: To evaluate efficacy of extended CPR (ECPR) performed by physicians in the simulated scenario of IHCA.   MATERIAL AND METHODS: High-fidelity simulations were performed in a simulation room equipped with a full spectrum of emergency devices. Earlier, the physicians (n = 60, five courses) participated in a threeday training in the use of extracorporeal techniques. Eventually, 12 participants were divided into 4-member teams that were involved in three stages (assessed in terms of duration and quality) of scenario such as 1. Advanced Life Support (ALS) activities; 2. preparation of the extracorporeal membrane oxygenation device (ECMO); 3. cannulation and activation of ECMO.   RESULTS: All teams completed successfully scenario within recommended time of 60 minutes (ranged from 33 min. 55 sec. to 37 min.) after IHCA. In details, decision to activate ECMO team was taken between 8 min. 45 sec. and 14 min. 15 sec of scenario, ECMO device prepared within 10 min. 5 sec. to 15 min. 30 sec. whereas peripheral vessels cannulated in 4 min. 14 sec. to 6 min. 10 sec. Of note, all evaluated times were the shortest for teams with decisive leaders.   CONCLUSIONS: Implementation of ECPR procedure is possible within recommended time after IHCA. It has also been shown that training with application of high-fidelity simulation techniques is of paramount importance in achievement and maintenance of ECPR skills, not only manual but also in effective communication.

Abstract

INTRODUCTION: The survival rate of patients after in-hospital cardiac arrest (IHCA) is poor. The implementation of novel technologies to conventional cardio-pulmonary resuscitation (CPR) may improve clinical outcomes.   Aim: To evaluate efficacy of extended CPR (ECPR) performed by physicians in the simulated scenario of IHCA.   MATERIAL AND METHODS: High-fidelity simulations were performed in a simulation room equipped with a full spectrum of emergency devices. Earlier, the physicians (n = 60, five courses) participated in a threeday training in the use of extracorporeal techniques. Eventually, 12 participants were divided into 4-member teams that were involved in three stages (assessed in terms of duration and quality) of scenario such as 1. Advanced Life Support (ALS) activities; 2. preparation of the extracorporeal membrane oxygenation device (ECMO); 3. cannulation and activation of ECMO.   RESULTS: All teams completed successfully scenario within recommended time of 60 minutes (ranged from 33 min. 55 sec. to 37 min.) after IHCA. In details, decision to activate ECMO team was taken between 8 min. 45 sec. and 14 min. 15 sec of scenario, ECMO device prepared within 10 min. 5 sec. to 15 min. 30 sec. whereas peripheral vessels cannulated in 4 min. 14 sec. to 6 min. 10 sec. Of note, all evaluated times were the shortest for teams with decisive leaders.   CONCLUSIONS: Implementation of ECPR procedure is possible within recommended time after IHCA. It has also been shown that training with application of high-fidelity simulation techniques is of paramount importance in achievement and maintenance of ECPR skills, not only manual but also in effective communication.

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Keywords

in-hospital cardiac arrest, cardio-pulmonary resuscitation, extended cardio-pulmonary resuscitation, simulation, education

About this article
Title

Implementation of extended cardiopulmonary resuscitation procedure in in-hospital cardiac arrest: a preliminary simulated study

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 6, No 1 (2021)

Article type

Research paper

Pages

10-20

Published online

2021-02-26

DOI

10.5603/DEMJ.a2021.0002

Bibliographic record

Disaster Emerg Med J 2021;6(1):10-20.

Keywords

in-hospital cardiac arrest
cardio-pulmonary resuscitation
extended cardio-pulmonary resuscitation
simulation
education

Authors

Maciej Sip
Mateusz Puslecki
Marek Dabrowski
Tomasz Klosiewicz
Marcin Ligowski
Sebastian Stefaniak
Lukasz Szarpak
Christopher Paprocki
Marek Jemielity
Bartlomiej Perek

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