The Resusci Anne® mannequin reinforces skills such as (i) high-quality management of the airway with endotracheal tubes and supraglottic airway devices, (ii) real defibrillation and synchronised ECG, (iii) pulse monitoring, (iv) insertion for intravenous treatment, and (v) Sociodemographic characteristics of the sampleĪ total of 142 students participated in the study, of which 80% (n = 111) were women and 20% (n = 31) were men. The research was conducted in a university simulation laboratory using the Resusci Anne® mannequin for advanced CPR. Therefore, the objective of this study was to identify the pauses that occur during ALS situations in high-fidelity simulation scenarios and the frequency and duration of pauses among student nurses.Īn exploratory descriptive cross-sectional study, involving high-fidelity simulation, was conducted. 17 Having a greater understanding of the preshock pauses may help to improve the quality of CPR and propose new educational interventions. Understanding the reasons behind preshock pauses can help to improve team organisation as well as reduce the time of pauses. 16 Furthermore, this methodology enables the analysis of factors that may delay the start of chest compressions in a CA scenario as well as the time in delivering the first countershock. 12 The use of high-fidelity simulation has been recommended to improve competency acquisition 13 and attitudes towards ALS training, permit self-guided or self-directed learning, minimise obstacles for practicing CPR, 14, 15 and improve teamwork, therefore facilitating more positive patient outcomes during an ALS situation. It has been observed that training nurses to recognise shockable rhythms and initiate defibrillation manoeuvres in simulated environments reduces the time to the first countershock. HIGH QUALITY CPR PAUSES IN COMPRESSION MANUAL10 To properly use a manual defibrillator and avoid preshock pauses, nurses must possess the ability to recognise ventricular arrhythmias, assess the pulse rate, and initiate CPR as soon as possible. 10 This greater loss of time may result from users who do not interrupt the “chain of advice” from the AED, which is associated with a prolonged time interval from AED activation to the first shock. 3, 8 In regards to defibrillation during situations of ALS with nursing professionals, the use of a manual defibrillator is recommended 9 over an automated external defibrillator (AED) as the use of an AED may be associated with less success owing to a greater loss of time. 7 In addition, the same association recommends limiting the duration of pauses to no more than 10 s and to coordinate tasks during said pauses.Įarly identification and defibrillation of shockable rhythms have been shown to increase survival rates in cases of pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF). 6 The American Heart Association (AHA) recommends that the first chest compressions be initiated in less than 1 min during in-hospital cardiorespiratory arrest (CA). 4, 5 Increasing attention has been given to the proportion of time spent performing or interrupting chest compressions. Prolonged preshock pauses-pauses between chest compressions before defibrillatory shock-have been associated with decreased survival rates and reduced reperfusion success after defibrillation. 1, 2 Early initiation of cardiopulmonary resuscitation (CPR) manoeuvres and the minimisation of pauses between chest compressions have been identified as two of the most important components of high-quality CPR. In recent years, the importance of performing high-quality advanced life support (ALS) in hospital settings has been analysed to improve mortality and morbidity rates.
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