Page 27 - Delaware Medical Journal - July/August 2019

CASE REPORT
CONCLUSION
None of the factors studied (gender,

affected the quality of chest compressions.

similarly. The majority of providers did not perform HQCC within the AHA guidelines due to a high compression rate, which in turn resulted in a steady decline of depth. Almost all of the participants exhibited bias, a majority against those individuals who were females, short- statured, and fatigued. Individuals directing resuscitations should be aware of this potential for bias when forming teams and assigning roles.
ACKNOWLEDGMENTS: We would like to recognize Dr. Susan Coffey Zern and the staff in the Virtual Education in Simulation Training (VEST) Center for their support of this study.
CONTRIBUTING AUTHORS
■ MANDIE M. BAKER, MD is a board-certified Emergency Medicine Physician practicing with the Greater San Antonio Emergency Physicians in San Antonio, TX in the Methodist Health System. She completed her EM residency at Christiana Care in 2017.
■ EMILY M. GRANITTO, MD is a board-certified Emergency Medicine Physician practicing
at Christiana Care. She completed her EM residency at Christiana Care in 2016.
■ AMY CHERICO, RN, BSN is a Certified Clinical Research Coordinator working for the Department of Emergency Medicine Research at Christiana Care.
■ MIA A. PAPAS, PhD, is the Corporate Director of the Value Institute in the Christiana Care Health System and oversees the research and operations of the Institute. She is the Site Principal Investigator for the Delaware Center for Translational Research. Dr. Papas received
her PhD in Epidemiology from the Johns Hopkins School of Public Health.
■ LEILA P. GETTO, MD is a board-certified Emergency Medicine Physician practicing at Christiana Care and is a Clinical Assistant Professor at Sidney Kimmel Medical College at Thomas Jefferson University. She is currently the Associate Program Director of the EM residency at Christiana Care and is the Director of Emergency Simulation.
REFERENCES
1. Kleinman M, Brennan E, Goldberger Z,
et al. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality. Circulation. 2015; 132:S414-S435. https://doi.org/10.1161/ CIR.0000000000000259.
2. Perberdy MA, Silver A, Ornato JP. Effect
of caregiver gender, age, and feedback prompts on chest compression rate
and depth. Resuscitation. 2009 Oct 80(10):1169-74. https://doi.org: 10.1016/j. resuscitation.2009.07.003. Epub 2009 Aug 11.
3. Lin CC, Kuo CW, Ng CJ, et al. Rescuer factors predict high-quality CPR — a manikin-based study of health care providers. Am J Emerg Med. 2016 Jan; 34(1): 20-4. https://doi.org: 10.1016/j. ajem.2015.09.001. Epub 2015 Sep 7.
4. Schneider AP, Nelson DJ, Brown DD. In- hospital cardiopulmonary resuscitation: a 30-year review. J Am Fam Pract. 1993 Mar- Apr;6(2):91-101.
5. Parker LR, Monteith MJ, Moss-Racusin CA, et al. Promoting concern about gender bias with evidence-based confrontation. Journal of Experimental Social Psychology 74(2018) 8-23. https://doi.org/10.1016/j. jesp.2017.07.009.
6. Ly DP, Seabury SA, Jena AB. Differences in incomes of physicians in the United States by race and sex: observational study. BMJ 2016; 353:i2923. https://dx.doi.org/10.1136/bmj.i2923.
7. http://www.census.gov/topics/health. html. United States Census Bureau. Last accessed 5/11/18.
8. Fryar CD, GU Q, Ogden CL, Flegal KM.
Anthropometric reference data for children and adults: United States, 2011-2014. National Center for Health Statistics. Vital Health Stat 3(39). 2016.
9. Crowe C, Bobrow BJ, Vadeboncoeur TF, et al. Measuring and improving cardiopulmonary resuscitation quality inside the emergency department. Resuscitation. 2015 Aug; 93:8-13. https://doi.org/10.1016/j. resuscitation.2015.04.031. Epub 2015
May 8.
10. Sarma S, Buccuti H, Chitnis A, et al. Real-time mobile device-assisted chest compression during cardiopulmonary resuscitation. American Journal of Cardiology. 120(2);196-200, 2017
Jul 15. https://doi.org/10.1016/j. amjcard.2017.04.007. Epub 2017 May 4.
11. Cheng A, Overly F, Kessler D, et al. Perception of CPR quality: Influence of CPR feedback, just-in-time CPR training and provider role. Resuscitation. 2015 Feb;87:44-50. https://doi.org/10.1016/j. resuscitation.2014.11.015. Epub 2014 Nov 26.
12. Yamankas S, Huh JY, Nishiyama K, et
al. The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial. PLoS ONE. 12(12);e0189412.2017. https://doi.org/10.1371/journal. pone.0189412.
13. Hong MY, Tsou JY, Tsao PC, et al.. Push- fast recommendation on performing CPR causes excessive chest compression rates, a manikin model. Am J Emerg Med. 2014 Dec;32(12):1455-9. https:// doi.org/10.1016/j.ajem.2014.08.074. Epub 2014 Sep 6.
14. Lee DH, Kim CW, Kim SE, et al.. Use of a step stool during resuscitation improved the quality of chest compression in simulated resuscitation. Emerg Med Australas. 2012 Aug;24(4):369-73. https://doi.org/10.1111/j.1742- 6723.2012.01545.x. Epub 2012 Mar 27.
15. Cheng A, Lin Y, Nadkarni V, et al.. The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study. CJEM. 2018 Jan;20(1):80-88. https://doi.org/10.1017/cem.2017.12. Epub 2017 Apr 3.
16. Ebbeling LG, Esposito EC, Fried DA, et al. Abstract 245: Increasing rescuer height is associated with higher frequency of leaning during chest compressions. Circulation 2010;122:A245.
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