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Simulation training enables emergency medicine providers to rapidly and safely initiate extracorporeal cardiopulmonary resuscitation (ECPR) in a simulated cardiac arrest scenario.

Abstract：

BACKGROUND:Extracorporeal cardiopulmonaryresuscitation (ECPR) is emerging as a viable rescue strategy for refractory out-of-hospital cardiac arrest. In the U.S., limited training of emergency medicine providers is a barrier to widespread implementation. AIMS:Test the hypothesis that emergency medicine physicians and nurses can acquire and retain the skills to rapidly and safely initiate ECPR using high-fidelity simulation. STUDY DESIGN:Prospective interventional study. SETTING:U.S. tertiary academic medical center. SUBJECTS:Emergency medicine physicians and nurses with no prior ECPR/ECMO experience. METHODS:Teams of three physicians and three nurses underwent a two-day ECPR training course including didactics, hands-on training, and simulation. Teams were videotaped initiating ECPR in a high-fidelity simulation scenario before and after simulation training. The primary outcome was the proportion of simulations in which full ECPR support was achieved within 30 min of patient arrival. RESULTS:Five teams completed the entire study. Full ECPR support was achieved within 30 min of patient arrival in 11/15, 15/15, and 15/15 attempts at baseline (B), post-testing (PT) and 3-month post-testing (3-PT), respectively (p = 0.06). Intervals (mean ± sd) required to achieve full ECPR support at B, PT, and 3-PT were 25.8±5.3, 17.2±4.6, and 19.2±1.9 min respectively (p < 0.05 for B vs. PT and 3-PT). CONCLUSION:High fidelity simulation training is effective in preparing emergency medicine physicians and nurses to rapidly and safely initiate ECPR in a simulated cardiac arrest scenario, and should be considered when implementing an ED-based ECPR program.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Whitmore SP,Gunnerson KJ,Haft JW,Lynch WR,VanDyck T,Hebert C,Waldvogel J,Havey R,Weinberg A,Cranford JA,Rooney DM,Neumar RW

doi

10.1016/j.resuscitation.2019.03.002

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

68-73

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(19)30061-9

journal_volume

138

pub_type

杂志文章

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