Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest: A randomised controlled trial

Rasmus Meyer Lyngby; Lyra Clark; Julie Samsoee Kjoelbye; Roselil Maria Oelrich; Annemarie Silver; Helle Collatz Christensen; Charlotte Barfod; Freddy Lippert; Dimitra Nikoletou; Tom Quinn; Fredrik Folke

doi:10.1016/j.resplu.2021.100082

Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest: A randomised controlled trial

Rasmus Meyer Lyngby, Lyra Clark, Julie Samsoee Kjoelbye, Roselil Maria Oelrich, Annemarie Silver, Helle Collatz Christensen, Charlotte Barfod, Freddy Lippert, Dimitra Nikoletou, Tom Quinn, Fredrik Folke

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

OBJECTIVES: To investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.

DESIGN: Non-blinded randomised controlled simulation trial.

SETTING: One Emergency Medical Service trust in Copenhagen.

PARTICIPANTS: 32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.

INTERVENTION: Participant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.

MAIN OUTCOME MEASURES: The primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.

RESULTS: The intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.

CONCLUSIONS: Real-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.

Original language	English
Article number	100082
Journal	Resuscitation Plus
Volume	5
Pages (from-to)	1-10
ISSN	2666-5204
DOIs	https://doi.org/10.1016/j.resplu.2021.100082
Publication status	Published - 2021

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Lyngby, R. M., Clark, L., Kjoelbye, J. S., Oelrich, R. M., Silver, A., Christensen, H. C., Barfod, C., Lippert, F., Nikoletou, D., Quinn, T., & Folke, F. (2021). Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest: A randomised controlled trial. Resuscitation Plus, 5, 1-10. [100082]. https://doi.org/10.1016/j.resplu.2021.100082

Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest : A randomised controlled trial. / Lyngby, Rasmus Meyer; Clark, Lyra; Kjoelbye, Julie Samsoee; Oelrich, Roselil Maria; Silver, Annemarie; Christensen, Helle Collatz ; Barfod, Charlotte ; Lippert, Freddy; Nikoletou, Dimitra; Quinn, Tom; Folke, Fredrik.

In: Resuscitation Plus, Vol. 5, 100082, 2021, p. 1-10.

Research output: Contribution to journal › Journal article › Research › peer-review

Lyngby, RM, Clark, L, Kjoelbye, JS, Oelrich, RM, Silver, A, Christensen, HC , Barfod, C , Lippert, F, Nikoletou, D, Quinn, T & Folke, F 2021, 'Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest: A randomised controlled trial', Resuscitation Plus, vol. 5, 100082, pp. 1-10. https://doi.org/10.1016/j.resplu.2021.100082

Lyngby, Rasmus Meyer ; Clark, Lyra ; Kjoelbye, Julie Samsoee ; Oelrich, Roselil Maria ; Silver, Annemarie ; Christensen, Helle Collatz ; Barfod, Charlotte ; Lippert, Freddy ; Nikoletou, Dimitra ; Quinn, Tom ; Folke, Fredrik. / Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest : A randomised controlled trial. In: Resuscitation Plus. 2021 ; Vol. 5. pp. 1-10.

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abstract = "OBJECTIVES: To investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.DESIGN: Non-blinded randomised controlled simulation trial.SETTING: One Emergency Medical Service trust in Copenhagen.PARTICIPANTS: 32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.INTERVENTION: Participant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.MAIN OUTCOME MEASURES: The primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.RESULTS: The intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.CONCLUSIONS: Real-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.",

author = "Lyngby, {Rasmus Meyer} and Lyra Clark and Kjoelbye, {Julie Samsoee} and Oelrich, {Roselil Maria} and Annemarie Silver and Christensen, {Helle Collatz} and Charlotte Barfod and Freddy Lippert and Dimitra Nikoletou and Tom Quinn and Fredrik Folke",

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doi = "10.1016/j.resplu.2021.100082",

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TY - JOUR

T1 - Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest

T2 - A randomised controlled trial

AU - Lyngby, Rasmus Meyer

AU - Clark, Lyra

AU - Kjoelbye, Julie Samsoee

AU - Oelrich, Roselil Maria

AU - Silver, Annemarie

AU - Christensen, Helle Collatz

AU - Barfod, Charlotte

AU - Lippert, Freddy

AU - Nikoletou, Dimitra

AU - Quinn, Tom

AU - Folke, Fredrik

PY - 2021

Y1 - 2021

N2 - OBJECTIVES: To investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.DESIGN: Non-blinded randomised controlled simulation trial.SETTING: One Emergency Medical Service trust in Copenhagen.PARTICIPANTS: 32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.INTERVENTION: Participant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.MAIN OUTCOME MEASURES: The primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.RESULTS: The intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.CONCLUSIONS: Real-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.

AB - OBJECTIVES: To investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.DESIGN: Non-blinded randomised controlled simulation trial.SETTING: One Emergency Medical Service trust in Copenhagen.PARTICIPANTS: 32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.INTERVENTION: Participant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.MAIN OUTCOME MEASURES: The primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.RESULTS: The intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.CONCLUSIONS: Real-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.

U2 - 10.1016/j.resplu.2021.100082

DO - 10.1016/j.resplu.2021.100082

M3 - Journal article

C2 - 34223348

VL - 5

SP - 1

EP - 10

JO - Resuscitation Plus

JF - Resuscitation Plus

SN - 2666-5204

M1 - 100082

ER -