Cardiac Arrest: Improving CPR Quality and Survival

心脏骤停：提高心肺复苏质量和生存率

• 批准号: 7653698
• 负责人: BENJAMIN S ABELLA
• 金额: $ 13.47万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-10 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7653698
• 关键词: Address; Animals; Attention; Biological Assay; Blood Circulation; Carbon Dioxide; Cardiopulmonary Resuscitation; Cerebrum; Characteristics; Chest; Clinical; Communication; Community Hospitals; Consensus; Crowding; Data; Defibrillators; Devices; Education; Electric Countershock; Environmental air flow; Event; Feedback; Guidelines; Health; Health Personnel; Heart Arrest; Hospitals; Hour; Human; Leadership; Measurement; Measures; Methodology; Methods; Modality; Monitor; Outcome; Oxygen saturation measurement; Patients; Performance; Physiological; Physiology; Play; Recommendation; Reporting; Research; Resuscitation; Role; System; Task Performances; Technology; Time; Training; Training and Education; Ventricular Fibrillation; Work; base; falls; improved; investigator training; microsystems; novel; programs; sensor; simulation; visual feedback

DESCRIPTION (provided by applicant): Cardiac arrest remains the number one killer in the developed world, despite the introduction of cardiopulmonary resuscitation (CPR) and defibrillation over 50 years ago. In the U.S. alone, cardiac arrest afflicts over 300,000 people each year, with less than 10% of patients surviving the event despite often extensive resuscitative efforts. The survival benefit of well-performed CPR is well documented in animal studies and several subjective human observational reports, but little objective data exists regarding CPR quality during actual cardiac arrest. Recent studies have challenged the notion that CPR is uniformly performed according to established consensus guidelines. In addition, simulation studies have suggested that audio feedback on CPR performance may improve quality. Work from our group and others using novel monitoring technology has recently shown that the quality of multiple CPR parameters is inconsistent and often falls short of guideline recommendations, even when performed by well-trained medical personnel. We hypothesize that resuscitation performance is limited by a variety of human factors including poor establishment of team leadership at the arrest and poor attention to task performance. We further hypothesize that real-time automatic monitoring of CPR with frequent audio and visual feedback to rescuers will improve the quality of CPR performance. We will measure human factor parameters such as team leadership and task assignment during in-hospital cardiac arrests via direct observation by trained investigators. By careful study of the human factors of resuscitation team function, we will be able to impact CPR education and training by targeting deficiencies leading to poor performance. Using monitor/defibrillators with specialized CPR sensors and audio feedback prompts, we will assay whether CPR performance is improved by feedback, and will then determine in patients with improved CPR quality, whether an improvement in survival is achieved. Using this exciting new monitoring and feedback modality, we hope to establish a standard for optimal CPR performance methodology that would broadly impact the health and survival of patients who suffer from cardiac arrest both in the hospital and the community.

描述（由申请人提供）： 尽管引入了心脏骤停 在50年前，心肺复苏（CPR）和除颤。仅在美国，心脏骤停每年就会遭受30万人的折磨，尽管经常进行了广泛的复苏努力，但不到10％的患者幸存下来。表现出色的心肺复苏术的生存优势在动物研究和几项主观人类观察报告中得到了充分的证明，但是在实际心脏骤停过程中，关于CPR质量的客观数据很少。最近的研究挑战了CPR根据既定共识指南均匀执行的观念。此外，模拟研究表明，关于CPR性能的音频反馈可以提高质量。我们小组和其他人使用新颖监测技术的工作最近表明，即使由受过良好训练的医疗人员执行，多个CPR参数的质量也不一致，并且通常没有指导建议。我们假设复苏绩效受到各种人为因素的限制，包括在被捕时建立团队领导力和对任务绩效的关注不佳。我们进一步假设，通过频繁的音频和视觉反馈对救援人员进行实时自动监测CPR将提高CPR性能的质量。我们将通过训练有素的调查人员的直接观察期间在院内心脏骤停期间进行人为因素参数，例如团队领导和任务分配。通过仔细研究复苏团队功能的人为因素，我们将能够通过靶向缺陷来影响CPR教育和培训，导致性能差。使用具有专门的CPR传感器和音频反馈提示的监视器/除颤器，我们将测定是否通过反馈来提高CPR性能，然后确定CPR质量提高的患者，是否可以提高生存率。使用这种令人兴奋的新监测和反馈方式，我们希望建立一个最佳CPR绩效方法的标准，该方法将广泛影响在医院和社区中遭受心脏骤停的患者的健康和生存。