The CPR outcomes of online medical video instruction versus on-scene medical instruction using simulated cardiac arrest stations

BMC Emergency Medicine

Research Article

Yuwares Sittichanbuncha¹  Jarupol Tuangsirisup¹  Sorravit Sawatmongkornkul¹  Chaiyaporn Yuksen¹  Kittisak Sawanyawisuth² 

[1] Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 10400, Bangkok, Thailand;Department of Medicine, Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;The Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, 40002, Khon Kaen, Thailand;

关键词: Ventricular tachycardia;    Pulseless electrical activity;    CPR;    Online;    On-scene;   

DOI  :  10.1186/s12873-016-0092-3

 received in 2015-11-29, accepted in 2016-06-07,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundNon-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures. There are limited data on the effects of telemedicine in cardiac arrest situations in the literature particularly in Asian settings.MethodsThis study was conducted by using two simulated cardiac arrest stations during the 2014 annual Thai national conference in emergency medicine. These two stations, nos. 5 and 11, were a part of the conference activity called “EMS rally” which was comprised of 14 stations. Both stations were shockable and out-of-hospital cardiac arrest situations; station 5 was online instructed, while station 11 was on-scene instructed. There were 14 representative teams from each province from all over Thailand who participated in the rally. Each team had one physician, one nurse, and two emergency medicine technicians. Eight CPR outcomes were evaluated and compared between the online versus on-scene situations.ResultsThere were 14 representative teams that participated in the study; a total of 14 physicians, 14 nurses, and 28 emergency medicine technicians. The average ages of participants in all three occupations were between the second and third decade of life. The percentages of participants with more than 3 years in ambulance experience was 7.1, 64.3, and 53.6 % in the physicians, nurses, and EMTs groups. The median times of all outcomes were significantly longer in the online group than the on-scene group including times from start to chest compression (total 102 vs 36 s), total times from the start to VT/VF detection (187 vs 99 s); times from VT/VF detection to the first defibrillation (57 vs 28 s); and times from the start of adrenaline injection (282 vs 165 s). The percentages of using amiodarone (21.43 % vs 57.14 %; p value < 0.001), establishment of a definitive airway (35.71 % vs 100 %; p value 0.003), and correct detections of pulseless electrical activity (PEA) (28.57 % vs 100 %; p value < 0.001) were significantly lower in the online group than the on-scene group. The high quality CPR outcomes between the online group and on-scene group were comparable.ConclusionsThe online medical instruction may have worse CPR outcomes compared with on-scene medical instruction in shockable, simulated CPR scenarios. Further studies are needed to confirm these results.

【 授权许可】

CC BY   
© The Author(s). 2016