ACLS interventional skills: Are we as good as we should be?

Area of Science:

• Emergency Medicine
• Cardiovascular Resuscitation Science

Background:

• Advanced Cardiac Life Support (ACLS) certification is crucial for healthcare providers managing cardiac emergencies.
• Assessing the practical skills competency of ACLS-certified personnel is vital for patient safety and outcomes.

Purpose of the Study:

• To evaluate the hands-on skills competence of Advanced Cardiac Life Support (ACLS) certified personnel.
• To compare subjective confidence with objective performance in ACLS skills.

Main Methods:

• An observational, cross-sectional study design was employed.
• Participants underwent the ACLS mega code examination using a Laerdal manikin and standardized code carts.
• Subjective confidence and objective skills were assessed.

Main Results:

• Pass rates for tachyarrhythmia management were low: 12% for stable and 57% for unstable scenarios.
• Key skill deficits included appropriate medication use, post-conversion maintenance, energy selection, and shock delivery.
• Significant discrepancies exist between perceived and actual skill proficiency.

Conclusions:

• ACLS providers overestimate their proficiency in managing tachyarrhythmias.
• Actual performance in critical scenarios highlights significant gaps in core ACLS skills.
• Recommendations include enhanced observation of ACLS training and recertification processes to ensure consistent skill evaluation.