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Implementation of a Team-Focused High-Performance CPR (TF-HP-CPR) Protocol Within a Rural Area EMS System.

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This summary is machine-generated.

Implementing team-focused, high-performance cardiopulmonary resuscitation (TF-HP-CPR) in a rural EMS system showed a trend toward improved return of spontaneous circulation (ROSC) for out-of-hospital cardiac arrest (OHCA) patients. Further research is needed due to small sample sizes.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Quality Improvement

Background:

  • Team-focused, high-performance cardiopulmonary resuscitation (TF-HP-CPR) is endorsed by the American Heart Association to improve outcomes in out-of-hospital cardiac arrest (OHCA).
  • A rural Virginia emergency medical services (EMS) system, with oversight from an emergency nurse practitioner (ENP), sought to enhance its continuous quality improvement (QI) initiatives.

Purpose of the Study:

  • To evaluate the impact of implementing a TF-HP-CPR protocol on the rate of return of spontaneous circulation (ROSC) in patients experiencing OHCA.
  • To assess the effectiveness of a QI project focused on TF-HP-CPR within a rural EMS setting.

Main Methods:

  • A QI project was implemented in January 2018, including TF-HP-CPR education, mock code evaluations, and the use of a blind insertion airway device.
  • The protocol integrated end-tidal carbon dioxide (ETCO2) monitoring and post-resuscitation report cards.
  • A comparative analysis was conducted on OHCA patients from a 16-week period before and after protocol implementation.

Main Results:

  • The post-implementation group (11 patients) showed a higher ROSC rate (54.55%) compared to the pre-implementation group (13 patients, 38.46%).
  • This represented a 16.09% increase in ROSC, but the difference was not statistically significant (p = 0.6824).
  • Small sample sizes were identified as a likely reason for the lack of statistical significance.

Conclusions:

  • The implementation of a TF-HP-CPR protocol demonstrated a positive trend in improving ROSC rates for OHCA patients.
  • Despite the observed increase, the findings did not reach statistical significance.
  • A larger-scale study is recommended to further evaluate the efficacy of TF-HP-CPR in this EMS system.