Minimizing Pulse Check Duration Through Educational Video Review.

Authors

David Yamane, GW Department of Anesthesiology and Critical Care; GW Department of Emergency Medicine
Patrick McCarville, GW Department of Emergency Medicine
Natalie Sullivan, GW Department of Emergency Medicine
Evan Kuhl, GW Department of Emergency Medicine
Carolyn Robin Lanam, GW Department of Emergency Medicine
Christopher Payette, GW Department of Emergency Medicine
Anahita Rahimi-Saber, GW Department of Emergency Medicine
Jennifer Rabjohns, GW Department of Emergency Medicine
Andrew D Sparks, GW Department of Emergency Medicine
Keith Boniface, GW Department of Emergency Medicine
Aaran Drake, GW Department of Emergency Medicine

Document Type

Journal Article

Publication Date

10-20-2020

Journal

West J Emerg Med

Volume

21

Issue

6

Abstract

INTRODUCTION: The American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) recommend pulse checks of less than 10 seconds. We assessed the effect of video review-based educational feedback on pulse check duration with and without point-of-care ultrasound (POCUS).

METHODS: Cameras recorded cases of CPR in the emergency department (ED). Investigators reviewed resuscitation videos for ultrasound use during pulse check, pulse check duration, and compression-fraction ratio. Investigators reviewed health records for patient outcomes. Providers received written feedback regarding pulse check duration and compression-fraction ratio. Researchers reviewed selected videos in multidisciplinary grand round presentations, with research team members facilitating discussion. These presentations highlighted strategies that include the following: limit on pulse check duration; emphasis on compressions; and use of "record, then review" method for pulse checks with POCUS. The primary endpoint was pulse check duration with and without POCUS.

RESULTS: Over 19 months, investigators reviewed 70 resuscitations with a total of 325 pulse checks. The mean pulse check duration was 11.5 ± 8.8 seconds (n = 224) and 13.8 ± 8.6 seconds (n = 101) without and with POCUS, respectively. POCUS pulse checks were significantly longer than those without POCUS (P = 0.001). Mean pulse check duration per three-month block decreased statistically significantly from study onset to the final study period (from 17.2 to 10 seconds [P

CONCLUSION: Consistent with previous studies, POCUS prolonged pulse checks. Educational interventions were associated with significantly decreased overall pulse-check duration, with an enhanced effect on pulse checks involving POCUS. Performance feedback and video review-based education can improve CPR by increasing chest compression-fraction ratio.

APA Citation

Yamane, D., McCarville, P., Sullivan, N., Kuhl, E., Lanam, C., Payette, C., Rahimi-Saber, A., Rabjohns, J., Sparks, A., Boniface, K., & Drake, A. (2020). Minimizing Pulse Check Duration Through Educational Video Review.. West J Emerg Med, 21 (6). Retrieved from https://hsrc.himmelfarb.gwu.edu/smhs_anesth_facpubs/487