The Stop-Only-While-Shocking algorithm reduces hands-off time by 17% during cardiopulmonary resuscitation: a simulation study

Lars Koch Hansen, Anna Mohammed, Magnus Pedersen, Lars Folkestad, Jacob Brodersen, Thomas Morris Hey, Nicolaj Lyhne Christensen, Rasmus Carter-Storch, Kristoffer Bendix, Morten Rix Hansen, Mikkel Brabrand

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

INTRODUCTION: Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios.

METHODS: The study was designed as a full-scale cardiac arrest simulation study including administration of drugs. Participants were randomized into using the Stop-Only-While-Shocking (SOWS) algorithm or the ERC2010 algorithm. In SOWS, chest compressions were only interrupted for a post-charging rhythm analysis and immediate shock delivery. A Resusci Anne HLR-D manikin and a LIFEPACK 20 defibrillator were used. The manikin recorded time and chest compressions.

RESULTS: Sample size was calculated with an α of 0.05 and 80% power showed that we should test four scenarios with each algorithm. Twenty-nine physicians participated in 11 scenarios. Hands-off time was significantly reduced 17% using the SOWS algorithm compared with ERC2010 [22.1% (SD 2.3) hands-off time vs. 26.6% (SD 4.8); P<0.05].

CONCLUSION: In full-scale cardiac arrest simulations, a minor change consisting of charging the defibrillator before rhythm check reduces hands-off time by 17% compared with ERC2010 guidelines.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Emergency Medicine
Vol/bind23
Udgave nummer6
Sider (fra-til)413-417
ISSN0969-9546
DOI
StatusUdgivet - 1. dec. 2016

Fingeraftryk

Manikins
Guidelines
Sample Size
Perfusion
Physicians
Pharmaceutical Preparations

Citer dette

Hansen, Lars Koch ; Mohammed, Anna ; Pedersen, Magnus ; Folkestad, Lars ; Brodersen, Jacob ; Hey, Thomas Morris ; Christensen, Nicolaj Lyhne ; Carter-Storch, Rasmus ; Bendix, Kristoffer ; Hansen, Morten Rix ; Brabrand, Mikkel. / The Stop-Only-While-Shocking algorithm reduces hands-off time by 17% during cardiopulmonary resuscitation : a simulation study. I: European Journal of Emergency Medicine. 2016 ; Bind 23, Nr. 6. s. 413-417.
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title = "The Stop-Only-While-Shocking algorithm reduces hands-off time by 17{\%} during cardiopulmonary resuscitation: a simulation study",
abstract = "INTRODUCTION: Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios.METHODS: The study was designed as a full-scale cardiac arrest simulation study including administration of drugs. Participants were randomized into using the Stop-Only-While-Shocking (SOWS) algorithm or the ERC2010 algorithm. In SOWS, chest compressions were only interrupted for a post-charging rhythm analysis and immediate shock delivery. A Resusci Anne HLR-D manikin and a LIFEPACK 20 defibrillator were used. The manikin recorded time and chest compressions.RESULTS: Sample size was calculated with an α of 0.05 and 80{\%} power showed that we should test four scenarios with each algorithm. Twenty-nine physicians participated in 11 scenarios. Hands-off time was significantly reduced 17{\%} using the SOWS algorithm compared with ERC2010 [22.1{\%} (SD 2.3) hands-off time vs. 26.6{\%} (SD 4.8); P<0.05].CONCLUSION: In full-scale cardiac arrest simulations, a minor change consisting of charging the defibrillator before rhythm check reduces hands-off time by 17{\%} compared with ERC2010 guidelines.",
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The Stop-Only-While-Shocking algorithm reduces hands-off time by 17% during cardiopulmonary resuscitation : a simulation study. / Hansen, Lars Koch; Mohammed, Anna; Pedersen, Magnus; Folkestad, Lars; Brodersen, Jacob; Hey, Thomas Morris ; Christensen, Nicolaj Lyhne ; Carter-Storch, Rasmus ; Bendix, Kristoffer; Hansen, Morten Rix; Brabrand, Mikkel.

I: European Journal of Emergency Medicine, Bind 23, Nr. 6, 01.12.2016, s. 413-417.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - The Stop-Only-While-Shocking algorithm reduces hands-off time by 17% during cardiopulmonary resuscitation

T2 - a simulation study

AU - Hansen, Lars Koch

AU - Mohammed, Anna

AU - Pedersen, Magnus

AU - Folkestad, Lars

AU - Brodersen, Jacob

AU - Hey, Thomas Morris

AU - Christensen, Nicolaj Lyhne

AU - Carter-Storch, Rasmus

AU - Bendix, Kristoffer

AU - Hansen, Morten Rix

AU - Brabrand, Mikkel

PY - 2016/12/1

Y1 - 2016/12/1

N2 - INTRODUCTION: Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios.METHODS: The study was designed as a full-scale cardiac arrest simulation study including administration of drugs. Participants were randomized into using the Stop-Only-While-Shocking (SOWS) algorithm or the ERC2010 algorithm. In SOWS, chest compressions were only interrupted for a post-charging rhythm analysis and immediate shock delivery. A Resusci Anne HLR-D manikin and a LIFEPACK 20 defibrillator were used. The manikin recorded time and chest compressions.RESULTS: Sample size was calculated with an α of 0.05 and 80% power showed that we should test four scenarios with each algorithm. Twenty-nine physicians participated in 11 scenarios. Hands-off time was significantly reduced 17% using the SOWS algorithm compared with ERC2010 [22.1% (SD 2.3) hands-off time vs. 26.6% (SD 4.8); P<0.05].CONCLUSION: In full-scale cardiac arrest simulations, a minor change consisting of charging the defibrillator before rhythm check reduces hands-off time by 17% compared with ERC2010 guidelines.

AB - INTRODUCTION: Reducing hands-off time during cardiopulmonary resuscitation (CPR) is believed to increase survival after cardiac arrests because of the sustaining of organ perfusion. The aim of our study was to investigate whether charging the defibrillator before rhythm analyses and shock delivery significantly reduced hands-off time compared with the European Resuscitation Council (ERC) 2010 CPR guideline algorithm in full-scale cardiac arrest scenarios.METHODS: The study was designed as a full-scale cardiac arrest simulation study including administration of drugs. Participants were randomized into using the Stop-Only-While-Shocking (SOWS) algorithm or the ERC2010 algorithm. In SOWS, chest compressions were only interrupted for a post-charging rhythm analysis and immediate shock delivery. A Resusci Anne HLR-D manikin and a LIFEPACK 20 defibrillator were used. The manikin recorded time and chest compressions.RESULTS: Sample size was calculated with an α of 0.05 and 80% power showed that we should test four scenarios with each algorithm. Twenty-nine physicians participated in 11 scenarios. Hands-off time was significantly reduced 17% using the SOWS algorithm compared with ERC2010 [22.1% (SD 2.3) hands-off time vs. 26.6% (SD 4.8); P<0.05].CONCLUSION: In full-scale cardiac arrest simulations, a minor change consisting of charging the defibrillator before rhythm check reduces hands-off time by 17% compared with ERC2010 guidelines.

KW - cardiac arrest

KW - cardiopulmonary resuscitation

KW - chest compressions

KW - defibrillator charging

KW - hands-off time

KW - simulation study

U2 - 10.1097/MEJ.0000000000000282

DO - 10.1097/MEJ.0000000000000282

M3 - Journal article

C2 - 25951368

VL - 23

SP - 413

EP - 417

JO - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

SN - 0969-9546

IS - 6

ER -