Page 24 - Delaware Medical Journal - July/August 2019
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and depth, and may also be used to provide feedback for the performer. In addition, special Zoll software was utilized to record by-the-second data in order to analyze performance numbers. The survey was created with Research Electronic Data Capture (REDCap, Nashville, TN).
Selection of Participants
A convenience sample of 38 ACLS-
residents were enrolled. The residents were blinded as to the purpose of the study, and were not selected based on gender, age, Those who participated varied in gender, clothing, as some were in scrubs and some in suits or dresses.
Methods and Measurements
EM, EM/IM, and EM/FM residents
were randomly selected and brought
to the VEST Center, where they were asked to complete a pre-survey to
collect information regarding gender, height, exercise routines with respect to cardiovascular and strength training, the number of hours of sleep they had in the last 24 hours, and how they were feeling that day. Participants were randomly paired and were introduced to a scenario of a patient found to be pulseless in a hospital room without an automated external perform high-quality chest compressions, and told that they would not be asked to provide mouth-to-mouth resuscitation or intubation. They were reminded of the current AHA guidelines for high-quality compressions at this time. Each participant performed three two-minute rounds of chest compressions. Per AHA guidelines, the participant performed compressions alternating every two minutes.1
Compressions were performed for a total of 12 minutes of compressions per resident pair. This was designed to simulate a scenario in which there are a small number
or individuals able to perform chest compressions at any given time, requiring each individual to perform a total of six minutes of cardiopulmonary resuscitation (CPR) by alternating every two minutes
as is recommended. The participants had access to a step stool in the room to use
participants were inadvertently exposed to feedback from the Zoll device. Subsequent groups were blinded to this information. The Zoll device recorded the rate, depth, recoil, and interruption of compressions. Any compression that fell outside the
meeting AHA guidelines.” All chest compressions were observed by the study personnel and notes were made for each participant with respect to effort and usage of the stool at bedside. After completing the chest-compression portion of the study, the participants were asked to complete
a post-survey that included hypothetical scenarios to question them on who, in their opinion, would provide higher-quality chest compressions. These scenarios varied by gender, height, and fatigue level. They had three choices for each survey question, two choices exhibiting a bias, and another option stating that both would perform equally, exhibiting no bias (see Table 1).
Outcomes
The primary outcome was the percentage of emergency medicine residents who performed within AHA guidelines and the differences between males, females, tall, secondary outcome was the bias that exists between men and women against gender level.
Analysis
Differences in demographic characteristics by HQCC level were examined using a chi-square statistic for categorical variables including, but not limited to, gender, height, amount of sleep, routine weekly exercise, and routine weekly strength training. Differences in continuous
variables such as height and number of days of physical activity by HQCC were explored using a t-test. Longitudinal among gender, height, fatigue, and physical activity with HQCC. We determined a male to be considered “tall” if 6’1” or taller, and “short” if 5’7” or shorter. A woman was considered “tall” if 5’7” or taller and considered “short” if 5’2” or shorter. These height determinations were based off of reported U.S. Census Bureau and Centers for Disease Control and Prevention height statistics in the USA in 2012.7,8
Data on rate and depth of chest compressions was collected using a Zoll
Series device utilizes a set of pads with built-in electrodes to help monitor the compressor’s data with respect to rate
and depth, and in a real-life scenario may be used for pacing, cardioversion, and
to a main CPR metrics display monitor that has the capability of providing visual as well as audio feedback in real time. Participants were blinded to the purpose of the study.
RESULTS
11.6% of compressions were within the 2015 AHA guidelines. Of the 88.4% that did not meet the guidelines, failure was due primarily to the rate being too fast and less commonly to the depth of compressions dropping below two inches.
Gender, height, amount of sleep, and routine weekly exercise were not
in compression rate, depth, or percent of compressions within guidelines (see Table 1). Depth scores decreased over time (B = -91.7 (mm); 95% CI: (-119, -64)) whereas compression rate scores (B = 1.5 (comp/ min); 95% CI: 0.6, 2.5)) and the percent meeting AHA guidelines (B = 2.5%; 95% CI: 0.6%, 4.5%) increased over time. Over
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Del Med J | July/August 2019 | Vol. 91 | No. 4
