CPR-induced consciousness: A cross-sectional study of healthcare practitioners’ experience

Olaussen, Alexander; Shepherd, Matthew; Nehme, Ziad; Smith, Karen; Jennings, Paul; Bernard, Stephen; Mitra, Biswadev

doi:10.1016/j.aenj.2016.07.002

Cited by 21 publications

(37 citation statements)

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“…If mirrored in practice it would mean that the majority of UK paramedics would attend a patient experiencing CPR-IC during their career. The perceptions of interfering, and non-interfering CPR-IC were diverse and did not conform to criteria previously identified by Olaussen et al (2016). The features that were most commonly deemed to interfere with the resuscitation were often related to the paramedic rather than the patient and could potentially be overcome with education.…”

Section: Resultsmentioning

confidence: 94%

“…Cardiopulmonary Resuscitation-Induced Consciousness (CPR-IC) is a condition whereby a patient appears to regain some level of consciousness during cardiac arrest when chest compressions are being performed, even though they have no return of spontaneous circulation, and was first reported in the literature three decades ago (Lewinter, Carden, Nowak, Enriquez & Martin, 1989). There has been an increase in the number of case reports describing the phenomenon in the intervening years (Bihari & Rajajee, 2008;Pound, Verbeek & Cheskes, 2016;Tobin & Mihm, 2009), however, there remains limited evidence in relation to the physiological mechanism behind CPR-IC (Georgiou, Papathanassoglou & Xanthos, 2014;Imberti, Bellinzona, Riccardi, Pagani & Langer, 2003), the incidence of CPR-IC (Olaussen et al, 2017) and practitioners' experiences of CPR-IC (Olaussen et al, 2016). Of particular concern is the potential impact that CPR-IC may have on resuscitation attempts.…”

Section: Introductionmentioning

confidence: 99%

“…Of particular concern is the potential impact that CPR-IC may have on resuscitation attempts. Resuscitation guidelines advocate the provision of high quality, minimally interrupted chest compressions ( Soar et al, 2015 ); however, work by Olaussen et al (2016) identified that CPR-IC could compromise the delivery of effective resuscitation, thereby reducing the chances of a successful outcome. It was suggested that CPR-IC could be classified as interfering or non-interfering based upon the impact it had on the resuscitation attempt.…”

Section: Introductionmentioning

confidence: 99%

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An exploration of UK paramedics’ experiences of cardiopulmonary resuscitation-induced consciousness

Gregory

Mays

Kilner

et al. 2021

British Paramedic Journal

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<sec id="s1"> Introduction: Consciousness may occur during cardiopulmonary resuscitation despite the absence of a palpable pulse. This phenomenon, known as CPR-Induced Consciousness (CPR-IC), was first described over three decades ago and there has been an increase in case reports describing it. However, there remains limited evidence in relation to the incidence of CPR-IC and to practitioners’ experiences of it. </sec> <sec id="s2"> Methods: A mixed-methods, cross-sectional survey of paramedics who were registered with the Health and Care Professions Council (HCPC) and working in the United Kingdom (UK) at the time of the survey. Participants who had experienced CPR-IC were asked to provide details about the number of episodes, a description of how consciousness was manifested and whether or not it interfered with resuscitation. </sec> <sec id="s3"> Results: 293 eligible participants completed the study and 167 (57%) said that they had witnessed CPR-IC. Of those, over 56% reported that they had experienced it on at least two occasions. CPR-IC was deemed to interfere with resuscitation in nearly 50% of first experiences but this fell to around 31% by the third experience. The most common reasons for CPR-IC to interfere with resuscitation were: patient resisting clinical interventions, increased rhythm and pulse checks, distress, confusion and reluctance to perform CPR. </sec> <sec id="s4"> Conclusions: The prevalence of CPR-IC in our study was similar to that in earlier studies; however, unlike the other studies, we did not define what constituted interfering CPR-IC. Our findings suggest that interference may be related as much to the exposure of the clinician to CPR-IC as to any specific characteristic of the phenomenon itself. </sec>

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Section: Resultsmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An exploration of UK paramedics’ experiences of cardiopulmonary resuscitation-induced consciousness

Gregory

Mays

Kilner

et al. 2021

British Paramedic Journal

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“…Cases on patients who show signs of awareness during Cardio Pulmonary Resuscitation (CPR), also called CPR induced consciousness (CPRIC) have been reported scarcely in the medical literature [ 1 ]. However, the phenomenon has gained more attention in the past two years than ever before [ 2 – 4 ], and a recent cross-sectional study shows that experienced health practitioners anecdotal reports of awareness during CPR/CPRIC is far more common than reflected in the medical literature [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Awareness during CPR has several clinical implications, yet no guidelines address these patients and protocols, e.g., on pain management/sedation is still at an early stage [ 6 ]. Health practitioners facing these clinical scenarios experience very different management strategies and diverging clinician opinions and express the desire of a uniform management/guideline regarding both the recognition of awareness/CPRIC and resuscitative efforts, which are challenged due to patient awareness [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac arrest teams perspectives on communication and ethical conflicts related to awareness during CPR, a focus group study protocol

Lundsgaard

2018

Scand J Trauma Resusc Emerg Med

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BackgroundAwareness during Cardio Pulmonary Resuscitation (CPR) also called CPR induced consciousness (CPRIC) is a rare, but increasingly reported condition with significant clinical implications. Health professionals lack guidelines about patients with CPRIC, and to this date, no studies have addressed the complexity of communication and ethical aspects when continuing CPR while the patient is conscious.MethodsWe aim to explore Cardiac arrest team members perspectives regarding communication and ethical conflicts related to awareness during CPR. We have designed a qualitative, descriptive study using focus groups to discuss and reflect on patients with awareness during CPR. Focus groups consist of cardiac arrest team members (senior and training medical doctors, nurses and hospital porters). We will be presenting already published case reports about patients with CPRIC to focus groups to facilitate discussion and debate regarding the team members perceptions. Data analysis is inductive and based on systematic text condensation.DiscussionPrevious studies have suggested that external stressors affect the performance of a Cardiac arrest team. As a result of our analysis, we will aim to describe communicative and ethical challenges and concerns regarding awareness during CPR. Recent studies in the area point to a desire for guidelines and we hope to contribute with knowledge, that can inform the further process when developing guidelines and training team members to handle these stressful and important cases.Trial registrationThe study involves no healthcare intervention on human participants.

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Approach to cardiopulmonary resuscitation induced consciousness, an emergency medicine perspective

Pourmand

Hill

Yamane

et al. 2019

The American Journal of Emergency Medicine

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CPR-induced consciousness: A cross-sectional study of healthcare practitioners’ experience

Cited by 21 publications

References 20 publications

An exploration of UK paramedics’ experiences of cardiopulmonary resuscitation-induced consciousness

An exploration of UK paramedics’ experiences of cardiopulmonary resuscitation-induced consciousness

Cardiac arrest teams perspectives on communication and ethical conflicts related to awareness during CPR, a focus group study protocol

Approach to cardiopulmonary resuscitation induced consciousness, an emergency medicine perspective

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