Standardising communication to improve in-hospital cardiopulmonary resuscitation

• Published in: Resuscitation 2020-02, Vol.147, p.73-80
• Main Authors: Lauridsen, Kasper Glerup, Watanabe, Ichiro, Løfgren, Bo, Cheng, Adam, Duval-Arnould, Jordan, Hunt, Elizabeth A., Good, Grace L., Niles, Dana, Berg, Robert A., Nishisaki, Akira, Nadkarni, Vinay M.
• Format: Article
• Language: English
• Subjects: Advanced life support; Communication; Delphi technique; In-hospital cardiac arrest; Nontechnical skills; Simulation
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2019.12.013

Recommendations for standardised communication to reduce chest compression (CC) pauses are lacking. We aimed to achieve consensus and evaluate feasibility and efficacy using standardised communication during cardiopulmonary resuscitation (CPR) events. Modified Delphi consensus process to design standardised communication elements. Feasibility was pilot tested in 16 simulated CPR scenarios (8 scenarios with physician team leaders and 8 with chest compressors) randomized (1:1) to standardised [INTERVENTION] vs. closed-loop communication [CONTROL]. Adherence and efficacy (duration of CC pauses for defibrillation, intubation, rhythm check) was assessed by audiovisual recording. Mental demand and frustration were assessed by NASA task load index subscales. Consensus elements for standardised communication included: 1) team preparation 15−30 s before CC interruption, 2) pre-interruption countdown synchronized with last 5 CCs, 3) specific action words for defibrillation, intubation, and interrupting/resuming CCs. Median (Q1,Q3) adherence to standardised phrases was 98% (80%,100%). Efficacy analysis showed a median [Q1,Q3] peri-shock pause of 5.1 s. [4.4; 5.8] vs. 7.5 s. [6.3; 8.8] seconds, p