Video case review for quality improvement during cardiac arrest resuscitation in the emergency department. Issue 10 (28th June 2021)

• Record Type: Journal Article
• Authors: Brooks, Joseph T.; Pierce, Ayal Z.; McCarville, Patrick; Sullivan, Natalie; Rahimi‐Saber, Anahita; Payette, Christopher; Popova, Margarita; Koizumi, Narou; Pourmand, Ali; Yamane, David
• Is Part Of: International journal of clinical practice. Volume 75:Issue 10(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-06-28
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.14525
• Languages: English
• ISSNs: 1368-5031

Abstract

Abstract: Background: Out‐of‐hospital cardiac arrests are a leading global cause of mortality. The American Heart Association (AHA) promotes several important strategies associated with improved cardiac arrest (CA) outcomes, including decreasing pulse check time and maintaining a chest compression fraction (CCF) > 0.80. Video review is a potential tool to improve skills and analyse deficiencies in various situations; however, its use in improving medical resuscitation remains poorly studied in the emergency department (ED). We implemented a quality improvement initiative, which utilised video review of CA resuscitations in an effort to improve compliance with such AHA quality metrics. Methods: A cardiopulmonary resuscitation video review team of emergency medicine residents were assembled to analyse CA resuscitations in our urban academic ED. Videos were reviewed by two residents, one of whom was a senior resident (Postgraduate Year 3 or 4), and analysed using Spearman's rank correlation coefficient for numerous quality improvement metrics, including pulse check time, CCF, time to intravenous access and time to patient attached to monitor. Results: We collected data on 94 CA resuscitations between July 2017 and June 2020. Average pulse check time was 13.09 (SD ± 5.97) seconds, and 38% of pulse checks were <10 seconds. After the implementation of the video review process, there was a significant decrease in average pulse check time ( P = .01) and a significant increase in CCF ( P = .01) throughout the study period. Conclusions: Our study suggests that the video review and feedback process was significantly associated with improvements in AHA quality metrics for resuscitation in CA amongst patients presented to the ED.