Comparison of EMS Provider In-Transit Performance and Exertion with Standard and Experimental Resuscitation Protocols during Simulated Out-of-Hospital Cardiac Arrest.

OBJECTIVE: To assess the effect of a device-assisted out- of-hospital cardiac arrest (OHCA) resuscitation approach on provider performance during simulated transport. METHODS: BLS and ALS providers were randomized into control and experimental teams. Subjects were fitted with wireless heart rate (HR) monitors. Control teams simulated with standard protocols and equipment; experimental teams with resuscitation-automating devices and goal-directed protocols. Chest compression quality, pulmonary ventilation, defibrillation, and medication administration tasks were monitored; subjects' HR's were continuously recorded. RESULTS: Ten control and ten experimental teams completed the study (20 EMT-B's; 1 EMT-I, 8 EMT-C's, 11 EMT-P's) with similar resting HR's and age-predicted maximal HR's (mHR). All exhibited suboptimal in-transit resuscitation quality during initial simulations; HR did not differ significantly between the groups. Experimental teams exhibited improved chest compression and ventilation quality during transport along with lower subject HR. CONCLUSION: OHCA resuscitation automation improved the in-simulation quality of critical in-transit tasks and reduced provider exertion.