Abstract
Background
Educational aspects in the training of advanced life support (ALS) represent a key
role in critical care management of patients with out-of-hospital cardiac arrest (OHCA)
and received special attention in guidelines of various international societies. While
a positive association of feedback on ALS performance in training conditions is well
established, data on the impact of a real-life post-resuscitation feedback on both
ALS quality and outcome remain scarce and inconclusive. We aimed to elucidate the
impact of a standardized post-resuscitation feedback on quality of ALS and improvements
in patient outcome, in a real-life out-of-hospital setting.
Methods
We prospectively enrolled and analyzed 2209 patients presenting with OHCA receiving
resuscitation attempts by the municipal emergency medical service (EMS) of Vienna
over a two-year period. A standardized post-resuscitation feedback protocol was delivered
to the respective EMS-team to elucidate its impact on the quality of ALS.
Results
We observed that both chest compression rates and ratios were in accordance to recommendations
of recent guidelines. While interruptions of chest compressions longer than 30 s declined during the observation period (−6.5%) rates of the recommended chest compressions
during defibrillator-charging periods increased (+8.9%). Since the percentage of ROSC
and 30-day survival remained balanced, the frequencies of both survival until hospital
discharge (+6.3%) and favorable neurological outcome (+16%) in survivors significantly
increased during the observation period.
Conclusion
Improvements in the quality of advanced life support as well the patient outcome were
observed after the implementation of a standardized post-resuscitation feedback protocol.
Keywords
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Article info
Publication history
Published online: August 29, 2017
Accepted:
August 23,
2017
Received in revised form:
August 12,
2017
Received:
February 21,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2017.08.235.
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
