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Cardiac arrest team role pre-allocation and debriefing: A policy analysis of West Midlands hospitals
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Poster Presentations / Resuscitation 84S (2013) S8–S98
AP148 Preparing events in sport context during the cardiac arrest awareness week “VIVA!” in Italy Andrea Scapigliati 1,∗ , Niccolò Grieco 2 , Tommaso Pellis 3 , Giuseppe Ristagno 4 , Federico Semeraro 5 , Erga L. Cerchiari 5 1
Catholic University of the Sacred Heart, Rome, Italy Intensive Cardiac Care Unit & Prehospital Emergency, Milan, Italy 3 Intensive Care and Emergency Medical Service, Santa Maria degli Angeli Hospital, Pordenone, Italy 4 Istituto di ricerche farmacologiche “Mario Negri” –IRCCS, Milan, Italy 5 Maggiore Hospital, Bologna, Italy 2
Purpose of the study: On June 14th, 2012, the European Parliament called for a week of cardiac arrest awareness, to be held throughout Europe. The Italian Resuscitation Council (IRC) has answered to this call planning a structured project to best organize the “Viva!” week (that means both “alive” and “long life for”) on October 14th–20th 2013 (http://www.viva2013.it). Sport context is one out of six domains addressed by the project (work, school, sport, healthcare systems, public places, home). Despite excellent primary prevention, it is estimated that at least 100 persons per year die in Italy while practicing sport at different levels. Materials and methods: IRC has established a scientific board in order to produce educational tools targeting the lay population. Mass training events have been planned and started in sport contexts. Endorsement by National and local sport organizations, teams, media partners and testimonials has been requested. Furthermore “Viva!” is supporting the implementation of a new National law which makes CPR training and AED availability mandatory for each sport society in the Country. Results: The first “Viva!” public sport related event took place on 12th April, 2013. A public training event tailored on young athletes was held in the Rome swimming stadium in the context of an international conference on swimming pools safety. About 100 children and young adults from 10 to 22 years old (swimming club pupils and sport sciences students) have been trained in recognizing a cardiac arrest, alerting the EMS and performing good quality CPR summoning AED (http://www.viva2013.it/ calendario-eventi/9-4-2013/5th-international-conferenceswimming-pool-and-spa). Other events are following and partnerships are ongoing. A roundtable on implementation of AED law will be held during IRC national congress. Conclusions: Sport can be a powerful context to spread CPR awareness to general population. http://dx.doi.org/10.1016/j.resuscitation.2013.08.173 AP149 Cardiac arrest team role pre-allocation and debriefing: A policy analysis of West Midlands hospitals Couper 1 ,
Whitehead 2 ,
Keith Laura Melody 1 , Gavin D. Perkins 2
Teresa
1 Heart of England NHS Foundation Trust, Birmingham, UK 2 Warwick Medical School, University of Warwick, Coventry, UK
Study purpose: Cardiac arrest team role pre-allocation and educational post-event debriefing are associated with car-
diopulmonary resuscitation quality.1–3 Resuscitation guidelines recommend the use of these strategies in clinical practice.4 However, data regarding their uptake is lacking. The aim of this study was to describe the use of role pre-allocation and debriefing in UK NHS hospitals in the West Midlands. Materials and methods: Copies of resuscitation practice policy documents were requested from acute adult NHS trusts in the West Midlands Strategic Health Authority. We extracted data about the use of adult cardiac arrest team role pre-allocation and debriefing for each hospital that provides adult acute care services. Results: We obtained resuscitation policies from 17 NHS trusts (response rate 100%), which represented 23 acute hospital sites. All policies had been updated since 2010. Two hospitals (8.7%) allocate team roles during a meeting (pre-briefing) at each shift handover. Thirteen hospitals (56.5%) have a pre-defined team leader. Of these, six (26.1%) hospitals allocate other team roles in the policy document. Debriefing is provided at eight hospitals (34.8%). It is typically provided ad hoc (n = 6, 26.1%) based on either perceived need following a difficult resuscitation (n = 5, 21.7%) or resuscitation officer availability (n = 1, 4.3%). Two hospitals (8.7%) provide debriefing, led by the team leader, following every cardiac arrest. No hospital used cold debriefing or used objective CPR performance data as part of the debrief process. Conclusion: This analysis shows that few hospitals have implemented team role allocation or debriefing. Whilst some hospitals formally allocate team roles, only two hospitals arranged for staff to meet at each shift change. Debriefing is rarely provided following cardiac arrests. Where it does occur, it is generally provided for perceived psychological, rather than educational, benefit.
References 1. Couper K, Perkins GD. Debriefing after resuscitation. Curr Opin Crit Care 2013;19:188–94. 2. Edelson DP, et al. Improving in-hospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med 2008;168:1063–9. 3. Ong MEH, et al. Improving the quality of cardiopulmonary resuscitation by training dedicated cardiac arrest teams. Resuscitation 2013;84:508–14. 4. Soar J, et al. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010;81:e288–330.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.174 AP150 Implementation of hyperinvasive approach to out-of hospital cardiac arrest management: Results from presimulation and simulation phases of the “Prague OHCA study” Jan Belohlavek 1 , Hana Skalicka 1 , Ondrej Smid 1 , Ondrej Franek 2 , Milana Pokorna 2 , Jiri Danda 2 , Karel Kucera 2 , Jiri Jarkovsky 3 , Jan Rulisek 1 , Jaroslav Valasek 2 , Zdenek Schwarz 2 , Ales Linhart 1 1
General University Hospital, Prague, Czech Republic Prague Emergency Service, Prague, Czech Republic 3 Masaryk University, Brno, Czech Republic 2
Background: Out of hospital cardiac arrest (OHCA) bears a poor outcome. While initiating a prospective randomized study combining prehospital intraarrest hypothermia, mechanical chest compression device, intrahospital ECLS (extracorporeal life support) and early invasive investigation and treatment we encountered considerable logistic barriers arising into necessity to perform presimulation and simulation phase of the trial. Imple-
Poster Presentations / Resuscitation 84S (2013) S8–S98
AP148 Preparing events in sport context during the cardiac arrest awareness week “VIVA!” in Italy Andrea Scapigliati 1,∗ , Niccolò Grieco 2 , Tommaso Pellis 3 , Giuseppe Ristagno 4 , Federico Semeraro 5 , Erga L. Cerchiari 5 1
Catholic University of the Sacred Heart, Rome, Italy Intensive Cardiac Care Unit & Prehospital Emergency, Milan, Italy 3 Intensive Care and Emergency Medical Service, Santa Maria degli Angeli Hospital, Pordenone, Italy 4 Istituto di ricerche farmacologiche “Mario Negri” –IRCCS, Milan, Italy 5 Maggiore Hospital, Bologna, Italy 2
Purpose of the study: On June 14th, 2012, the European Parliament called for a week of cardiac arrest awareness, to be held throughout Europe. The Italian Resuscitation Council (IRC) has answered to this call planning a structured project to best organize the “Viva!” week (that means both “alive” and “long life for”) on October 14th–20th 2013 (http://www.viva2013.it). Sport context is one out of six domains addressed by the project (work, school, sport, healthcare systems, public places, home). Despite excellent primary prevention, it is estimated that at least 100 persons per year die in Italy while practicing sport at different levels. Materials and methods: IRC has established a scientific board in order to produce educational tools targeting the lay population. Mass training events have been planned and started in sport contexts. Endorsement by National and local sport organizations, teams, media partners and testimonials has been requested. Furthermore “Viva!” is supporting the implementation of a new National law which makes CPR training and AED availability mandatory for each sport society in the Country. Results: The first “Viva!” public sport related event took place on 12th April, 2013. A public training event tailored on young athletes was held in the Rome swimming stadium in the context of an international conference on swimming pools safety. About 100 children and young adults from 10 to 22 years old (swimming club pupils and sport sciences students) have been trained in recognizing a cardiac arrest, alerting the EMS and performing good quality CPR summoning AED (http://www.viva2013.it/ calendario-eventi/9-4-2013/5th-international-conferenceswimming-pool-and-spa). Other events are following and partnerships are ongoing. A roundtable on implementation of AED law will be held during IRC national congress. Conclusions: Sport can be a powerful context to spread CPR awareness to general population. http://dx.doi.org/10.1016/j.resuscitation.2013.08.173 AP149 Cardiac arrest team role pre-allocation and debriefing: A policy analysis of West Midlands hospitals Couper 1 ,
Whitehead 2 ,
Keith Laura Melody 1 , Gavin D. Perkins 2
Teresa
1 Heart of England NHS Foundation Trust, Birmingham, UK 2 Warwick Medical School, University of Warwick, Coventry, UK
Study purpose: Cardiac arrest team role pre-allocation and educational post-event debriefing are associated with car-
diopulmonary resuscitation quality.1–3 Resuscitation guidelines recommend the use of these strategies in clinical practice.4 However, data regarding their uptake is lacking. The aim of this study was to describe the use of role pre-allocation and debriefing in UK NHS hospitals in the West Midlands. Materials and methods: Copies of resuscitation practice policy documents were requested from acute adult NHS trusts in the West Midlands Strategic Health Authority. We extracted data about the use of adult cardiac arrest team role pre-allocation and debriefing for each hospital that provides adult acute care services. Results: We obtained resuscitation policies from 17 NHS trusts (response rate 100%), which represented 23 acute hospital sites. All policies had been updated since 2010. Two hospitals (8.7%) allocate team roles during a meeting (pre-briefing) at each shift handover. Thirteen hospitals (56.5%) have a pre-defined team leader. Of these, six (26.1%) hospitals allocate other team roles in the policy document. Debriefing is provided at eight hospitals (34.8%). It is typically provided ad hoc (n = 6, 26.1%) based on either perceived need following a difficult resuscitation (n = 5, 21.7%) or resuscitation officer availability (n = 1, 4.3%). Two hospitals (8.7%) provide debriefing, led by the team leader, following every cardiac arrest. No hospital used cold debriefing or used objective CPR performance data as part of the debrief process. Conclusion: This analysis shows that few hospitals have implemented team role allocation or debriefing. Whilst some hospitals formally allocate team roles, only two hospitals arranged for staff to meet at each shift change. Debriefing is rarely provided following cardiac arrests. Where it does occur, it is generally provided for perceived psychological, rather than educational, benefit.
References 1. Couper K, Perkins GD. Debriefing after resuscitation. Curr Opin Crit Care 2013;19:188–94. 2. Edelson DP, et al. Improving in-hospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med 2008;168:1063–9. 3. Ong MEH, et al. Improving the quality of cardiopulmonary resuscitation by training dedicated cardiac arrest teams. Resuscitation 2013;84:508–14. 4. Soar J, et al. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010;81:e288–330.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.174 AP150 Implementation of hyperinvasive approach to out-of hospital cardiac arrest management: Results from presimulation and simulation phases of the “Prague OHCA study” Jan Belohlavek 1 , Hana Skalicka 1 , Ondrej Smid 1 , Ondrej Franek 2 , Milana Pokorna 2 , Jiri Danda 2 , Karel Kucera 2 , Jiri Jarkovsky 3 , Jan Rulisek 1 , Jaroslav Valasek 2 , Zdenek Schwarz 2 , Ales Linhart 1 1
General University Hospital, Prague, Czech Republic Prague Emergency Service, Prague, Czech Republic 3 Masaryk University, Brno, Czech Republic 2
Background: Out of hospital cardiac arrest (OHCA) bears a poor outcome. While initiating a prospective randomized study combining prehospital intraarrest hypothermia, mechanical chest compression device, intrahospital ECLS (extracorporeal life support) and early invasive investigation and treatment we encountered considerable logistic barriers arising into necessity to perform presimulation and simulation phase of the trial. Imple-