Approaches to improving cardiac arrest resuscitation performance.

PURPOSE OF REVIEW: The survival rate from cardiac arrest remains poor despite advances in cardiopulmonary resuscitation (CPR) and postresuscitation therapies. Recent studies have documented many shortcomings during the performance of resuscitation care. We will review the various methods to improve the delivery of resuscitation care described in the current literature. RECENT FINDINGS: Despite the fact that quality of CPR has been shown to correlate with improved patient outcomes, conventional training methods are often insufficient in enabling healthcare providers to deliver high-quality resuscitation care. Use of simulation methods during resuscitation training can increase subsequent resuscitation quality. Additionally, automated feedback during resuscitation has been shown to improve CPR performance. Focused debriefing after resuscitation can improve CPR quality and increase initial resuscitation success. Finally, minimizing pauses in chest compressions by adopting cardiocerebral resuscitation (CCR) protocols can lead to better patient survival. Implementing these measures on a more widespread basis can improve resuscitation care and ultimately decrease patient mortality. SUMMARY: By adopting techniques such as simulation, automated feedback, training refreshers, debriefing and CCR, the quality of resuscitation performance can be increased. Future work needs to demonstrate that improved resuscitation performance correlates with decreased mortality.