Development of a program to improve compression depth and time to defibrillation in out-of-hospital cardiac arrest

About the Program

Category: Health (Best in Category)

Year: 2015

The program spearheaded by the Mecklenburg EMS Agency (Medic) was developed as a targeted intervention to improve patient survival rates to hospital discharge after experiencing out-of hospital cardiac arrest (OHCA). Building on the knowledge that quality cardiopulmonary resuscitation (CPR) and timely defibrillation are associated with increasing survival to hospital discharge from OHCA, the program developed, tested, and implemented an intervention for EMS/first responder personnel. This intervention established performance coaching during an OHCA to improve compression depth and time to defibrillation (TTD). The program development team conducted a study in a single emergency medical services (EMS) agency and utilized data collected from 815 patients treated between January 1, 2012-December 31, 2013. The program development used multiple Plan-Do-Study-Act (PDSA) cycles to train fire captains to translate performance data into active direction. Testing began in simulation with small-scale expansions prior to system-wide implementation. Performance metrics included average (reported as a percentage) and actual compression depth (reported in millimeters), and TTD (an average in seconds). A statistical shift was seen in means and standard deviations for both depth metrics, indicating that utilization of a CPR performance coach during OHCA improves opportunity for patient outcomes to hospital discharge.