Page 22 - Delaware Medical Journal - July/August 2019

Factors and Bias Impacting
the Quality of Chest Compressions
Mandie M. Baker, MD; Emily M. Granitto, MD; Amy Cherico, RN, BSN; Mia A. Papas, PhD; Leila P. Getto, MD
STUDY OBJECTIVE: High-quality chest compressions (HQCC) are a key component of cardiopulmonary resuscitation (CPR). The aim of this study was to determine associations between physical and lifestyle characteristics and the ability to perform HQCC. In addition, the study sought to explore whether intrinsic bias exists among emergency medicine residents and their perceptions of who performs adequate chest compressions with regard to gender, height, and fatigue level.
METHODS: A convenience sample of 38 Advanced Cardiovascular Life Support (ACLS)-certified Emergency Medicine (EM), Emergency Medicine/Internal Medicine (EM/IM), and Emergency Medicine/Family Medicine (EM/FM) residents were enrolled. Participants completed a pre-survey to collect demographic information and other individual factors. Participants then worked in pairs to perform chest compressions on a patient simulator, which aided in data collection of compression rate and depth. After performing compressions on the patient simulator, participants were asked to complete a post-performance survey.
RESULTS: 11.6% of compressions met 2015 American Heart Association (AHA) guidelines.1 Gender, height, amount of sleep, and routine weekly exercise were not associated with a significant difference in compression rate, depth, or percent of compressions within guidelines. Participants expressed bias against medical personnel who were female, fatigued, and less than average height. The majority of residents indicated bias, with higher rates of bias reported when fatigue (86.8%) or gender (92%) were examined.
CONCLUSION: Factors such as gender or height did not significantly affect the quality of chest compressions, but most of the residents exhibited bias. Individuals directing resuscitations should be aware of this potential for bias when forming teams and assigning roles during CPR.
166 Del Med J | July/August 2019 | Vol. 91 | No. 4
Abstract