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Enhancing CPR Quality: Insights from the Third Annual EMS Research Summit

The Third Annual EMS Research Summit focuses on real-time CPR quality metrics that harness data from local cardiac monitors and defibrillators. Participants will explore essential aspects of CPR performance, including compression rates, depth, and timing of interventions. Key manufacturers like Philips, Zoll, and Medtronic provide robust data for case evaluations, helping improve CPR protocols and outcomes. Insights from previous studies underline the importance of chest compression performance in patient survival, emphasizing the need for ongoing research in cardiac arrest management.

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Enhancing CPR Quality: Insights from the Third Annual EMS Research Summit

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  1. Third Annual EMS Research Summit Real-Time CPRQuality Metrics

  2. Background • All monitors used locally can collect data during the performance of CPR • Hands-on time • Compression rates and ratio • Compression depth and other compression information • CPR pauses (e.g., before and after defibrillation, etc.) • Data from these files are useful for crews, agencies, and research.

  3. Local Cardiac Monitor/Defibrillators Three device manufacturers used in the region: • Philips Electronics • Zoll Medical • Medtronic Physio-Control Philips Zoll Medtronic Medtronic

  4. Philips Q-CPR™ Average Compression Rate (per min.) & Depth Compressions Events Timeline Rhythm

  5. Zoll RescueNet™ Chest Compression Depth Compression Rate ECG CPR

  6. Physio-Control Code-Stat™ Events & Assorted Vital Signs Statistics (1-minute intervals) Compressions ROSC Rhythm Compressions

  7. Research Utility Monitor files generate data that can provide: • Individual case information • Research protocol implementation • Time data • Aggregate information • CPR quality across multiple cases • Identification of trends • Information to enhance other available data • Initial rhythm • Outcome data • Medication timing and impact

  8. Previous Research Several studies have recently used data from monitor files: • Large randomized clinical trials • PRIMED • Observational studies • Chest Compression Fraction in VF/VT • Quality of CPR—nationwide feasibility study in Denmark • Randomized studies of feedback • Real-time feedback study—ROC • Feedback study—Germany

  9. Previous Research continued… • Multicenter observational study of 506 CPR files (largest of its kind to date) • Investigated the association of chest compression fraction (CCF)* with survival in patients presenting in VF/VT • Evaluated CCF during the period prior to first shock • Conclusions: • More time spent performing chest compressions in the early phase of resuscitation substantially affects survival • Some questions are unanswered, and further studies are necessary Chest Compression Fraction Determines Survival in Patients with Out-of-Hospital VF • *Proportion of time spent delivering chest compressions.

  10. Agency Value Monitor files, when reviewed with the chart, can aid in: • Chart (incident report) writing • Cardiac arrest management QI/QA • CPR quality review • Protocol compliance • Reasons/Context for pauses in CPR • Best practices for cardiac arrest treatment • Objective measures of time • Agency-specific performance

  11. Code-Stat™ Case Report QI Feedback to Field Providers Overall Performance Initial Rhythm Compressions &Other Events(analysis, shocks, ROSC, etc.)

  12. Zoll CPR Summary Analysis QI Feedback to Field Providers Compression Depth (inches) Time On/Off Chest Compression Rate

  13. Philips Q-CPR Report Card QI Feedback to Field Providers Average Compression Rate Average Compression Depth Compression Depth (% adequate)

  14. Conclusions Cardiac monitor file data: • Is useful for objective case review • Can enhance treatment • Can help clarify the timing and effectiveness of protocol changes • Is critical to advancing the science of cardiac arrest care

  15. Questions?

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