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Hands-On Times, Adherence to Recommendations and Variance in Execution among Three Different CPR Algorithms: A Prospective Randomized Single-Blind Simulator-Based Trial

Author

Listed:
  • Sami Rifai

    (Department of Orthopedics and Trauma Surgery, Bethesda Hospital, 47053 Duisburg, Germany
    Department of Orthopedics, 360 Clinic, 40882 Ratingen, Germany
    These authors contributed equally to this work.)

  • Timur Sellmann

    (Department of Anaesthesiology and Intensive Care, Bethesda Hospital, 47053 Duisburg, Germany
    Department of Anaesthesiology, University of Witten/Herdecke, 58448 Witten, Germany
    These authors contributed equally to this work.)

  • Dietmar Wetzchewald

    (Institution for Emergency Medicine, 59755 Arnsberg, Germany)

  • Heidrun Schwager

    (Institution for Emergency Medicine, 59755 Arnsberg, Germany)

  • Franziska Tschan

    (Department of Psychology, University of Neuchatel, 2000 Neuchâtel, Switzerland)

  • Sebastian G. Russo

    (Department of Anaesthesiology, University of Witten/Herdecke, 58448 Witten, Germany
    Department of Anaesthesiology, Villingen-Schwenningen Hospital, 78052 Villingen-Schwenningen, Germany
    Department of Anaesthesiology, University of Goettingen, 37075 Goettingen, Germany)

  • Stephan Marsch

    (Department of Intensive Care, University Hospital, 4031 Basel, Switzerland)

Abstract

Background: Alternative cardiopulmonary resuscitation (CPR) algorithms, introduced to improve outcomes after cardiac arrest, have so far not been compared in randomized trials with established CPR guidelines. Methods: 286 physician teams were confronted with simulated cardiac arrests and randomly allocated to one of three versions of a CPR algorithm: (1) current International Liaison Committee on Resuscitation (ILCOR) guidelines (“ILCOR”), (2) the cardiocerebral resuscitation (“CCR”) protocol (3 cycles of 200 uninterrupted chest compressions with no ventilation), or (3) a local interpretation of the current guidelines (“Arnsberg“, immediate insertion of a supraglottic airway and cycles of 200 uninterrupted chest compressions). The primary endpoint was percentage of hands-on time. Results: Median percentage of hands-on time was 88 (interquartile range (IQR) 6) in “ILCOR” teams, 90 (IQR 5) in “CCR” teams ( p = 0.001 vs. “ILCOR”), and 89 (IQR 4) in “Arnsberg” teams ( p = 0.032 vs. “ILCOR”; p = 0.10 vs. “CCR”). “ILCOR” teams delivered fewer chest compressions and deviated more from allocated targets than “CCR” and “Arnsberg” teams. “CCR” teams demonstrated the least within-team and between-team variance. Conclusions: Compared to current ILCOR guidelines, two alternative CPR algorithms advocating cycles of uninterrupted chest compressions resulted in very similar hands-on times, fewer deviations from targets, and less within-team and between-team variance in execution.

Suggested Citation

  • Sami Rifai & Timur Sellmann & Dietmar Wetzchewald & Heidrun Schwager & Franziska Tschan & Sebastian G. Russo & Stephan Marsch, 2020. "Hands-On Times, Adherence to Recommendations and Variance in Execution among Three Different CPR Algorithms: A Prospective Randomized Single-Blind Simulator-Based Trial," IJERPH, MDPI, vol. 17(21), pages 1-12, October.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:21:p:7946-:d:436845
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    Cited by:

    1. Daniel Gödde & Florian Bruckschen & Christian Burisch & Veronika Weichert & Kevin J. Nation & Serge C. Thal & Stephan Marsch & Timur Sellmann, 2022. "Manual and Mechanical Induced Peri-Resuscitation Injuries—Post-Mortem and Clinical Findings," IJERPH, MDPI, vol. 19(16), pages 1-9, August.

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