Monitoring cardiopulmonary resuscitation quality in emergency departments: a national survey in China on current knowledge, attitudes, and practices

Abstract

Background To investigate current knowledge, attitudes, and practices for CPR quality control among emergency physicians in Chinese tertiary hospitals. Methods Anonymous questionnaires were distributed to physicians in 75 tertiary hospitals in China between January and July 2018. Results A total of 1405 respondents answered the survey without obvious logical errors. Only 54.4% respondents knew all criteria of high-quality CPR. A total of 91.0% of respondents considered CPR quality monitoring should be used, 72.4% knew the objective method for monitoring, and 63.2% always/often monitored CPR quality during actual resuscitation. The main problems during CPR were related to chest compression: low quality due to fatigue (67.3%), inappropriate depth (57.3%) and rate (54.1%). The use of recommended monitoring methods was reported as follows, ETCO2 was 42.7%, audio-visual feedback devices was 10.1%, coronary perfusion pressure was 17.9%, and invasive arterial pressure was 31.1%. A total of 96.3% of respondents considered it necessary to participate in regular CPR retraining, but 21.4% did not receive any retraining. The ideal retraining interval was considered to be 3 to 6 months, but the actual interval was 6 to 12 months. Only 49.7% of respondents reported that feedback devices were always/often used in CPR training. Conclusion Chinese emergency physicians were very concerned about CPR quality, but they did not fully understand the high-quality criteria and their impact on prognosis. CPR quality monitoring was not a routine procedure during actual resuscitation. The methods recommended in guidelines were rarely used in practice. Many physicians had not received retraining or received retraining at long intervals. Feedback devices were not commonly used in CPR training.

What factors are effective on the CPR duration of patients under extracorporeal cardiopulmonary resuscitation: a single-center retrospective study

“…Prognostic factors for CPR duration largely overlap with those for favorable outcomes [ 36 ]. Hence, monitoring and optimizing the prognostic factors for the duration of CPR can help to achieve the favorable outcomes [ 37 , 38 ]. This study highlighted the prognostic factors associated with the duration of CPR in patients undergoing ECPR following IHCA or OHCA.…”

Aprimorando a Ressuscitação Cardiopulmonar

“…Em outro estudo, Cheng et al, 6 utilizaram monitoramento em tempo real das manobras de RCP intra-hospitalar e as ações eram revistas e apresentadas em feedback semanal aos membros dos times de ressuscitação. 6 Zheng et al, 7 por meio de pesquisa com 1405 profissionais de 75 hospitais terciários na China, observaram que 91% reconheciam a necessidade de monitoramento da RCP e 67,3% entendiam que o principal problema durante a RCP era a qualidade das compressões torácicas, influenciada diretamente pela fadiga do operador. 7 Esta influência da fadiga foi também observada por Trowbridge et al, 8 que demonstraram redução significativa da profundidade das compressões torácicas dentro dos dois primeiros minutos do início das manobras de RCP, ressaltando a importância do revezamento de socorristas.…”

“…In another study, Cheng et al 6 used real-time monitoring of in-hospital CPR maneuvers and the actions were reviewed and presented in weekly feedback to members of the resuscitation teams. 6 Zheng et al, 7 through a survey of 1405 professionals from 75 tertiary hospitals in China, observed that 91% recognized the need for CPR monitoring and 67.3% understood that the main problem during CPR was the quality of chest compressions, directly influenced by operator fatigue. 7 This influence of fatigue was also observed by Trowbridge et al, 8 who demonstrated a significant reduction in the depth of chest compressions within the first two minutes of starting CPR maneuvers, highlighting the importance of alternating rescuers.…”