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A novel approach to life support training using "action-linked phrases".
Hunt, Elizabeth A; Cruz-Eng, Hillenn; Bradshaw, Jamie Haggerty; Hodge, Melanie; Bortner, Tammi; Mulvey, Christie L; McMillan, Kristen N; Galvan, Hannah; Duval-Arnould, Jordan M; Jones, Kareen; Shilkofski, Nicole A; Rodgers, David L; Sinz, Elizabeth H.
Affiliation
  • Hunt EA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns
  • Cruz-Eng H; Penn State Hershey Medical Center Department of Anesthesiology, Hershey, Pennsylvania, USA.
  • Bradshaw JH; Uniformed Services of the Health Sciences, Bethesda, Maryland, USA.
  • Hodge M; Penn State University College of Medicine, Hershey, Pennsylvania, USA.
  • Bortner T; Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA.
  • Mulvey CL; Penn State Hershey Medical Center Department of Anesthesiology, Hershey, Pennsylvania, USA; Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA.
  • McMillan KN; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns
  • Galvan H; Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA.
  • Duval-Arnould JM; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Division of Health Sciences Informatics, Baltimore, Maryla
  • Jones K; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Johns Hopkins Medicine Simulation Center, Baltimore, Maryland, USA.
  • Shilkofski NA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Anesthesiology and Critical Care Medicine, Baltimore, Maryland, USA; Johns Hopkins University School of Medicine Department of Pediatrics, Baltimore, Maryland, USA; Johns
  • Rodgers DL; Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA.
  • Sinz EH; Penn State Hershey Medical Center Department of Anesthesiology, Hershey, Pennsylvania, USA; Penn State University College of Medicine, Hershey, Pennsylvania, USA; Penn State Hershey Clinical Simulation Center, Hershey, Pennsylvania, USA; Penn State Hershey Medical Center Department of Neurosurgery,
Resuscitation ; 86: 1-5, 2015 Jan.
Article in En | MEDLINE | ID: mdl-25457379
ABSTRACT

BACKGROUND:

Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy.

METHODS:

We hypothesized that when individuals utilized specific, short, easy-to-state action phrases stating an observation followed by an associated intervention, there would be a higher likelihood that appropriate action would immediately occur. Phase I A retrospective analysis of residents in simulated CPAs measured what proportion verbalized "There's no pulse", statements and/or actions that followed and whether "Action-Linked Phrases" were associated with faster initiation of compressions. Phase II Two prospective, quasi-experimental studies evaluated if teaching three Action-Linked Phrases for Basic Life Support (BLS) courses or six Action-Linked Phrases for Advanced Cardiovascular Life Support (ACLS) courses was associated with increased use of these phrases.

RESULTS:

Phase I 62% (42/68) of residents verbalized "there's no pulse" during initial assessment of a pulseless patient, and only 16/42 (38%) followed that by stating "start compressions". Residents verbalizing this Action-Linked Phrase started compressions sooner than others (30s [IQR19-42] vs. 150 [IQR51-242], p < 0.001). Phase II In BLS courses, the three Action-Linked Phrases were used more frequently in the intervention group (226/270 [84%] vs. 14/195 [7%]; p < 0.001). In ACLS courses, the six Action-Linked Phrases were uttered more often in the intervention group (43% [157/368] vs. 23% [46/201], p < 0.001).

CONCLUSIONS:

Action-Linked Phrases innately used by residents in simulated CPAs were associated with faster initiation of compressions. Action-Linked Phrases were verbalized more frequently if taught as part of a regular BLS or ACLS course. This simple, easy to teach, and easy to implement technique holds promise for impacting cardiac arrest teams' performance of key actions.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Heart Arrest Type of study: Observational_studies / Risk_factors_studies Limits: Humans Language: En Journal: Resuscitation Year: 2015 Type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Heart Arrest Type of study: Observational_studies / Risk_factors_studies Limits: Humans Language: En Journal: Resuscitation Year: 2015 Type: Article