The association of recent simulation training and clinical experience of team leaders with cardiopulmonary resuscitation quality during in-hospital cardiac arrest

Johannes Wittig; Bo Løfgren; Rasmus P Nielsen; Rikke Højbjerg; Kristian Krogh; Hans Kirkegaard; Robert A Berg; Vinay M Nadkarni; Kasper G Lauridsen

doi:10.1016/j.resuscitation.2024.110217

The association of recent simulation training and clinical experience of team leaders with cardiopulmonary resuscitation quality during in-hospital cardiac arrest

Resuscitation. 2024 Apr 20:110217. doi: 10.1016/j.resuscitation.2024.110217. Online ahead of print.

Authors

Johannes Wittig¹, Bo Løfgren², Rasmus P Nielsen³, Rikke Højbjerg⁴, Kristian Krogh⁵, Hans Kirkegaard⁶, Robert A Berg⁷, Vinay M Nadkarni⁷, Kasper G Lauridsen⁸

Affiliations

¹ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Department of Medicine, Randers Regional Hospital, Randers, Denmark.
² Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Medicine, Randers Regional Hospital, Randers, Denmark.
³ Department of Anaesthesiology and Intensive Care, Gødstrup Hospital, Herning, Denmark.
⁴ Emergency Department, Aarhus University Hospital, Aarhus, Denmark.
⁵ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
⁶ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
⁷ Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
⁸ Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Department of Medicine, Randers Regional Hospital, Randers, Denmark; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA; Department of Anaesthesiology and Intensive Care, Randers Regional Hospital, Randers, Denmark. Electronic address: kglerup@clin.au.dk.

PMID: 38649086
DOI: 10.1016/j.resuscitation.2024.110217

Abstract

Objective: We aimed to investigate the association of recent team leader simulation training (<6 months) and years of clinical experience (≥4 years) with chest compression quality during in-hospital cardiac arrest (IHCA).

Methods: This cohort study of IHCA in four Danish hospitals included cases with data on chest compression quality and team leader characteristics. We assessed the impact of recent simulation training and experienced team leaders on longest chest compression pause duration (primary outcome), chest compression fraction (CCF), and chest compression rates within guideline recommendations using mixed effects models.

Results: Of 157 included resuscitation attempts, 45% had a team leader who recently participated in simulation training and 66% had an experienced team leader. The median team leader experience was 7 years [Q1; Q3: 4; 11]. The median duration of the longest chest compression pause was 16 seconds [10; 30]. Having a team leader with recent simulation training was associated with significantly shorter longest pause durations (difference: -7.11 seconds (95%-CI: -12.0; -2.2), p=0.004), a higher CCF (difference: 3 % (95%-CI: 2.0; 4.0%), p<0.001) and with less guideline compliant chest compression rates (odds ratio: 0.4 (95%-CI: 0.19; 0.84), p=0.02). Having an experienced team leader was not associated with longest pause duration (difference: -1.57 seconds (95%-CI: -5.34; 2.21), p=0.42), CCF (difference: 0.72 % (95%-CI: -0.3; 1.73), p=0.17) or chest compression rates within guideline recommendations (odds ratio: 1.55 (95%-CI: 0.91; 2.66), p=0.11).

Conclusion: Recent simulation training of team leaders, but not years of team leader experience, was associated with shorter chest compression pauses during IHCA.

Keywords: Cardiac arrest teams; Cardiopulmonary resuscitation; Chest compression pauses; Chest compression quality; Experience; In-hospital cardiac arrest; Leadership; Training.