Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2017

Open Access 01-12-2016 | Research article

Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study

Authors: Leopold Haffner, Moritz Mahling, Alexander Muench, Christoph Castan, Paul Schubert, Aline Naumann, Silke Reddersen, Anne Herrmann-Werner, Jörg Reutershan, Reimer Riessen, Nora Celebi

Published in: BMC Emergency Medicine | Issue 1/2017

Login to get access

Abstract

Background

Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario.

Methods

Final-year medical students (n = 57) were randomised to receive a 10-min computer-based CRM or a control training on ethics. Acting as team leaders, subjects performed resuscitation in a simulated cardiac arrest scenario before and after the training. Team members performed standardised overly shallow and fast chest compressions. We analysed how often the team leader recognised and corrected improper chest compressions, as well as communication and resuscitation quality.

Results

After the CRM training, team leaders corrected improper chest compressions (35.5%) significantly more often compared with those undergoing control training (7.7%, p = 0.03*). Consequently, four students have to be trained (number needed to treat = 3.6) for one improved chest compression scenario. Communication quality assessed by the Leader Behavior Description Questionnaire significantly increased in the intervention group by a mean of 4.5 compared with 2.0 (p = 0.01*) in the control group.

Conclusion

A computer-based, 10-min CRM training improved the recognition of ineffective chest compressions. Furthermore, communication quality increased. As guideline-adherent chest compressions have been linked to improved patient outcomes, our CRM training might represent a brief and affordable approach to increase chest compression quality and potentially improve patient outcomes.
Appendix
Available only for authorised users
Literature
1.
Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Gräsner J-T, Wenzel V. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015;95:81–99.CrossRefPubMed
2.
Edelson DP, Abella BS, Kramer-Johansen J, Wik L, Myklebust H, Barry AM, Merchant RM, Hoek TLV, Steen PA, Becker LB. Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resuscitation. 2006;71(2):137–45.CrossRefPubMed
3.
Capucci A, Aschieri D, Piepoli MF, Bardy GH, Iconomu E, Arvedi M. Tripling survival from sudden cardiac arrest via early defibrillation without traditional education in cardiopulmonary resuscitation. Circulation. 2002;106(9):1065–70.CrossRefPubMed
4.
Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O’Hearn N, Hoek TLV, Becker LB. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. Jama. 2005;293(3):305–10.CrossRefPubMed
5.
Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med. 1995;26(3):300–3.CrossRefPubMed
6.
Arshid M, Lo T-YM, Reynolds F. Quality of cardio-pulmonary resuscitation (CPR) during paediatric resuscitation training: time to stop the blind leading the blind. Resuscitation. 2009;80(5):558–60.CrossRefPubMed
7.
Greif R, Lockey A, Conaghan P, Lippert A, De Vries W, Monsieurs K: European Resuscitation Council Guidelines for Resuscitation. Section 10 Principles of Education in Resuscitation. Resuscitation. 2015;2015(95):287–300.
8.
Hunziker S, Johansson AC, Tschan F, Semmer NK, Rock L, Howell MD, Marsch S. Teamwork and leadership in cardiopulmonary resuscitation. J Am Coll Cardiol. 2011;57(24):2381–8.CrossRefPubMed
9.
Fernandez Castelao E, Russo SG, Cremer S, Strack M, Kaminski L, Eich C, Timmermann A, Boos M. Positive impact of crisis resource management training on no-flow time and team member verbalisations during simulated cardiopulmonary resuscitation: a randomised controlled trial. Resuscitation. 2011;82(10):1338–43.CrossRefPubMed
10.
Association WM: WMA declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects Revised by the 59th WMA General Assembly, Seoul, 2008.
11.
Rall M, Gaba D, Howard S, Dieckmann P. Human performance and patient safety, vol. 7. Philadelphia: Miller’s anesthesia Elsevier; 2009.
12.
Beauchamp TL, Childress JF. Principles of biomedical ethics. New York: Oxford University Press, Inc.; 2001.
13.
Cooper S, Wakelam A. Leadership of resuscitation teams: “Lighthouse Leadership”. Resuscitation. 1999;42(1):27.CrossRefPubMed
14.
Pizzi L, Goldfarb NI, Nash DB. Crew resource management and its applications in medicine. Making Health Care Safer. 2001;44:511–9.
15.
Hunziker S, Tschan F, Semmer NK, Zobrist R, Spychiger M, Breuer M, Hunziker PR, Marsch SC. Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: a prospective randomised simulator-based trial. BMC Emerg Med. 2009;9:3.CrossRefPubMedPubMedCentral
16.
Todd KH, Braslow A, Brennan RT, Lowery DW, Cox RJ, Lipscomb LE, Kellermann AL. Randomized, controlled trial of video self-instruction versus traditional CPR training. Ann Emerg Med. 1998;31(3):364–9.CrossRefPubMed
17.
Einspruch EL, Lynch B, Aufderheide TP, Nichol G, Becker L. Retention of CPR skills learned in a traditional AHA Heartsaver course versus 30-min video self-training: a controlled randomized study. Resuscitation. 2007;74(3):476–86.CrossRefPubMed
18.
Hunziker S, Bühlmann C, Tschan F, Balestra G, Legeret C, Schumacher C, Semmer NK, Hunziker P, Marsch S. Brief leadership instructions improve cardiopulmonary resuscitation in a high-fidelity simulation: A randomized controlled trial*. Crit Care Med. 2010;38(4):1086.CrossRefPubMed
19.
Jones T, Goss S, Weeks B, Miura H, Bassandeh D, Cheek DJ. The effects of high-fidelity simulation on salivary cortisol levels in SRNA students: a pilot study. ScientificWorldJOURNAL. 2011;11:86–92.CrossRefPubMed
20.
Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P, Metnitz P. Errors in administration of parenteral drugs in intensive care units: multinational prospective study. BMJ. 2009;338:b814.
21.
Byrne A, Sellen A, Jones J. Errors on anaesthetic record charts as a measure of anaesthetic performance during simulated critical incidents. Br J Anaesth. 1998;80(1):58–62.CrossRefPubMed
22.
Rall M, Manser T, Guggenberger H, Gaba D, Unertl K. Patientensicherheit und Fehler in der Medizin: Entstehung, Prävention und Analyse von Zwischenfällen. AINS Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie. 2001;36(6):321–30.PubMed
23.
Moher D, Schulz K, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001;285:1987–91.CrossRefPubMed
Metadata
Title
Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study
Authors
Leopold Haffner
Moritz Mahling
Alexander Muench
Christoph Castan
Paul Schubert
Aline Naumann
Silke Reddersen
Anne Herrmann-Werner
Jörg Reutershan
Reimer Riessen
Nora Celebi
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2017
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-017-0117-6

Other articles of this Issue 1/2017

BMC Emergency Medicine 1/2017 Go to the issue

Research article

A nationwide survey of first aid training and encounters in Norway

Research article

The association of duration of boarding in the emergency room and the outcome of patients admitted to the intensive care unit

Study protocol

Developing quality indicators for the care of patients with musculoskeletal injuries in the Emergency Department: study protocol

Research article

Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study

Correspondence

Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series

Research article

Trauma burden in Tanzania: a one-day survey of all district and regional public hospitals