Measurement and Feedback Tools - Monitoring CPR Quality in Real Time

Sudden cardiac arrest (SCA) continues to be a leading cause of death in the United States, claiming the lives of more than 300,000 people each year, with half of those cases occurring out of hospital. Despite advancements in defibrillation equipment and increased attention on CPR, only 5–10% of SCA victims leave the hospital alive. These bleak statistics illustrate the urgency for improving and implementing the chain of survival in order to increase the rate of survival to hospital discharge for cardiac arrest patients. The good news: Over the past few years, we have begun to see real improvements in survival rates in many communities.

Following SCA recognition and bystander assistance, EMS arrival and assumption of care becomes the most critical link in sustaining the life of a cardiac arrest victim. It cannot be overemphasized that high-quality CPR performance is essential for successful resuscitation.

In an attempt to improve performance, CPR measurement and feedback systems, such as the Philips HeartStart MRx with Q-CPR*, monitor performance and provide real-time feedback to the caregiver. Such devices measure compression rate, depth and ventilation characteristics in order to ensure high-quality CPR performance during an actual cardiac arrest. Recent studies in both EMS and hospital care have shown improved rates of pulse restoration with the use of these devices.

As CPR quality initiatives continue to grow, the practice of using real-time measurement and feedback during the resuscitation, combined with regular debriefing sessions using the data captured during patient events, has shown promising early results. Research has shown that debriefing with data obtained from measurement and feedback tools can increase subsequent CPR performance and improve outcomes from in-hospital SCA.

Strengthening the links within the cardiac chain of survival has the potential to significantly improve outcomes of cardiac arrest victims. SCA survival statistics demonstrate how detrimental a weakness can be in any one of the critical links involved in this sequence.


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References:

Benjamin S. Abella, MD, MPhil and Emily C. Esposito, BA "Strengthening the Chain of Survival Incorporating real-time quality measures improves cardiac arrest outcomes" Posted: 09/30/2009 Full Article Available Online: http://www.jems.com/article/patient-care/strengthening-chain-survival

*Q-CPR is a registered trademark of Laerdal Medical

Are you prepared...to respond?

 

Advancing quality and access to emergency care in remote locations - South Tyrol, Italy

The Weisses Kreuz provides special training for a group of paramedics, nurses, and physicians to have this group better prepared to operate under extreme weather conditions that from time to time occur in the high Alps. The top paramedics undergo the following program:

• 260 hours of theoretical training
• A minimum 160 hours of practical training
• Annual refresher training and recertification within specific disciplines

To enable continuous skill improvement and to ensure safe and optimal patient care, Weisses Kreuz introduced Q-CPR (quality CPR); a concept that, via sensors placed onto the patient’s chest, provides Italian Resuscitation Council compliant feedback on the quality of compressions delivered during resuscitation. Thanks to this new technology, Weisses Kreuz is now able to ensure quality treatment within yet another field.

Projects aiming to increase chance of survival

In addition to providing EMS to the local population of South-Tyrol, Weisses Kreuz is also concerned with the millions of tourists who visit the area every year. A sincere ambition to promote safety and improve clinical outcomes spurred the organization to launch the following project:

• Dissemination of CPR training in the population and
• Dissemination of First Aid knowledge

A minimum of 4000 school children will annually be using the self-directed MiniAnne/CPRAnytime program to learn and practice CPR. This endeavour will be followed up with research conducted by Professor Uwe Kreimeier, MD; Associate professor at the University of Munich Hospital, and his team.
                       
To encourage more people in the general population to gain First Aid knowledge, Weisses Kreuz introduced a free-of-charge smart First Aid guide for the iPhone and/or iPod Touch. The application, also compatible with other smart-phones, comes in German, Italian and English. So far the application has been downloaded more than 250 000 times worldwide.

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References:

Weisses Kreuz EMS, South Tyrol, Italy "Advancing quality and access to emergency care in remote locations" Full article available online: http://www.laerdal.com/UserStories/43276803/Advancing-quality-and-access-to-emergency-care-in-remote-locations

Are you prepared...to respond?

Shelter in Place

Shelter In Place (SIP) is an immediate response to a critical incident to reduce public exposure. The order to "Shelter-In-Place" may come at any time from local emergency services. Proper pre-planning and practice is the only way to ensure your workplace, institution, or home is prepared in the event Shelter-In-Place is required.

Shelter in place is an alternative to evacuation when:

* There is not enough time to safely evacuate the public at risk
* Residents are waiting for evacuation assistance
* There is a chemical release of limited duration (e.g. a release of sour gas due to a pipeline rupture)
* The public would be at higher risk if evacuated

If you are advised to shelter in place, listen to the radio and/or watch the television for instructions from emergency officials.

In a building with a Shelter-in-Place team, follow the instructions of the team members.

Are you prepared...to respond?

Preparedness

Facilitating efficient and effective management of an incident response is achieved through preparedness. Efforts to be prepared must be ongoing through planning, organizing, training, equipping, exercising, evaluating, and corrective action.



Using the preparedness cycle emergency management and first response personal should develop specific measures within their organization to enhance overall operational preparedness. Existing efforts and collaborative relationships can be leveraged when developing, refining, and expanding all-hazardous preparedness programs.

More information on Preparedness can be found on the FEMA web site.