Oral Themed Presentation
Background: : Healthcare providers struggle to provide guideline-compliant chest compressions (CC) during pediatric cardiac arrest . CPR feedback devices have been shown to improve cardiopulmonary resuscitation (CPR) quality, but CPR providers still tend to overestimate the quality of chest compressions (CC) delivered during cardiac arrest . This persistent misperception of CPR quality may influence the ability of providers to improve their delivery of CPR in future resuscitations . Clinical debriefing with quantitative CPR data is one potential strategy to address this issue,, but institutions often struggle to regularly conduct debriefings in the clinical environment . Demonstrating poor provider perception of CPR performance may provide additional motivation for institutions to implement clinical debriefing programs. A recent study showed that including a CPR Coach on the resuscitation team improves CPR performance . What is unknown is how the integration of a CPR Coach influences perception of CPR quality.
Research Question: : We aimed to describe the impact of a CPR Coach on healthcare provider perception of CPR quality during simulated pediatric cardiac arrest.
We hypothesized that teams with a CPR Coach will have improved healthcare provider perception of CPR quality in comparison to teams without a CPR Coach.
Methodology: : We conducted secondary analysis of data collected from a multicenter, randomized trial of 200 healthcare providers who participated in a simulated pediatric cardiac arrest. Participants were randomized to having a CPR Coach vs. no CPR Coach. CPR Coaches provided feedback on CPR performance and helped to coordinate key tasks. All teams utilized CPR feedback technology. CPR quality was collected by the defibrillator, and perceived CPR quality was collected by surveying participants after the scenario. We calculated the difference between perceived and measured quality of CPR and defined accurate perception as no more than 10% deviation from measured quality of CPR.
Results: : Teams with a CPR coach were more likely to accurately estimate CC depth in comparison to teams without a CPR coach (OR 2.97, 95%CI 1.61 - 5.46, p < 0.001). There was no significant difference detected in accurate perception of CC rate between groups (OR 1.33, 95%CI 0.77 – 2.32, p = 0.32). Amongst teams with a CPR coach, the CPR coach had the best CC depth perception (80%) compared with the rest of the team (team leader 40%, airway 55%, CPR provider 30%) (p = 0.003). No differences were found in perception of CC rate between roles (p = 0.86).
Discussion/Conclusions: : Healthcare providers improved their perception of CPR depth with a CPR Coach present. The CPR Coach had the best perception of CC depth.