The University of Chicago Chronicle reports:
New technology has allowed researchers at the University to measure, for the first time, how closely well-trained hospital staff comply with established guidelines for cardio-pulmonary resuscitation. The results reveal room for improvement.
“You can’t fix what you can’t measure,” Becker said. “Performing CPR was like driving a car without a speedometer, based more on feel than on feedback. Now, with a device that tells us how fast we are going, we think we can rein in the speeders and speed up those who fall behind.”
The key to this study was an investigational monitor/defibrillator device that records the rate and depth of chest compressions, the rate and volume of ventilations, and the presence or absence of a pulse. It also notes when no compressions are being performed and calculates total “no-flow” time, as well as the fraction of time during a cardiac arrest when there is no blood flow.
In this study, the cardiac arrest response team at the University Hospitals used the device to measure the quality of CPR during the first five minutes of each resuscitation attempt on 67 patients who suffered a cardiac arrest at the Hospitals between Dec. 11, 2002, and April 5, 2004. The results, which were broken down into 30-second segments, were compared to guidelines the American Heart Association developed.
The guidelines recommend 100 chest compressions per minute to a depth of at least 38 millimeters (about 1.5 inches). They call for a ventilation rate of 12 to 16 breaths a minute, and they advise keeping the no-flow fraction — the fraction of time in cardiac arrest without chest compressions — under 0.17 (about 10 seconds out of every minute.)
In 28 percent of the cases, chest compression rates fell below 90 per minute. Thirty-seven percent of the chest compressions were too shallow. Ventilation rates were usually too high; in 61 percent of the 30-second segments, ventilation rates were over 20 per minute. In 40 percent of cases, the no-flow fraction rose above 0.20.
The results of the study should hardly surprise anyone who’s been involved with in-house codes. JAMA editorial is located here (.pdf). Does anyone know what device was used by researchers, so we can link to it?