Training for the Game of Life: An Innovative Approach to Resuscitation Training Strategies to Maximize Team Performance

Abstract : Athletes rigorously train on teamwork, communication and skills to bring home a win. Saving the life of a patient suffering a cardiac arrest is the biggest game healthcare providers “play” but the health care team gets limited, if any, practice. In-hospital cardiac arrests (IHCA) in the adult population are estimated at 290,000 a year. Studies demonstrate cardiopulmonary resuscitation (CPR) could restore circulation (ROSC) 40% to 60% of the time but the more significant numbers are survival to hospital discharge and cognitive function post arrest. Recent estimates of survival to hospital discharge are at 23%. Reports of functional impairment vary but have been noted at 40% after IHCA. Factors that could improve survival include compliance with CPR priorities such as immediate initiation of chest compressions, maintenance of an adequate chest compression fraction (CCF), and early defibrillation if appropriate. A study by Sullivan et al. demonstrated improved performance of the initial CPR priorities with short, training sessions conducted every three months focusing on choreography and teamwork in the first few minutes (FFM) of an IHCA. This presentation will describe an approach to quarterly training sessions conducted over two years that includes FFM training alternating with short booster sessions that focus on skills training and knowledge assessment. Skills training focuses on quality chest compression and defibrillator refreshers. Knowledge assessment includes ETCO2 concepts, debriefing a code response after viewing a cardiac arrest video, and drug box reviews. The two year period also covers required skills for AHA recertification such as choking and pediatric CPR.