scholarly journals Video case review for quality improvement during cardiac arrest resuscitation in the emergency department

Author(s):  
JT Brooks ◽  
A Pierce ◽  
P McCarville ◽  
N Sullivan ◽  
A Rahimi‐Saber ◽  
...  
Author(s):  
Joseph Brooks ◽  
Ayal Pierce ◽  
Patrick McCarville ◽  
Natalie Sullivan ◽  
Anahita Rahimi-Saber ◽  
...  

Background: Cardiac arrests (CA) are a leading global cause of mortality. The American Heart Association (AHA) promotes several important strategies associated with improved cardiac arrest outcomes, including decreasing pulse check time and maintaining a chest compression fraction (CCF) > 0.80. Video review is a potential tool to improve skills and analyze deficiencies in various situations, however its use in improving medical resuscitation remains poorly studied in the emergency department (ED). We implemented a quality improvement initiative, which utilized video review of cardiac arrest resuscitations in an effort to improve compliance with such AHA quality metrics. Methods: A cardiopulmonary resuscitation Video Review Team (CoVeRT) of emergency medicine residents were assembled to analyze CA resuscitations in our urban academic ED. Videos were reviewed by two residents, one of whom was a senior resident (PGY-3 or -4), and analyzed for numerous quality improvement metrics, including pulse check time, CCF, time to intravenous access, and time to patient attached to monitor. Results: We collected data on 94 cardiac arrest resuscitations between July 2017 and June 2020. Average pulse check time was 13.09 (SD ±5.97) seconds, and 38% of pulse checks were less than 10 seconds. After the implementation of the video review process, there was a significant decrease in average pulse check time (p=0.01) and a significant increase in CCF (p=0.01) throughout the study period. Conclusions: Our study suggests that the video review and feedback process was significantly associated with improvements in AHA quality metrics for resuscitation in CA among patients presented to the ED.


Author(s):  
Michael D. April ◽  
Allyson Arana ◽  
Joshua C. Reynolds ◽  
Jestin N. Carlson ◽  
William T. Davis ◽  
...  

2021 ◽  
Vol 43 ◽  
pp. 62-68
Author(s):  
Su Yeong Pyo ◽  
Gwan Jin Park ◽  
Sang Chul Kim ◽  
Hoon Kim ◽  
Suk Woo Lee ◽  
...  

Brain Injury ◽  
2013 ◽  
Vol 28 (3) ◽  
pp. 298-303
Author(s):  
Susanne Abdulla ◽  
Anton Conrad ◽  
Karl-Peter Schwemm ◽  
Mark P. Stienstra ◽  
Edward L. Gorsselink ◽  
...  

2020 ◽  
Vol 9 (1) ◽  
pp. e000688
Author(s):  
Czer Anthoney Enriquez Lim ◽  
Julie Oh ◽  
Erick Eiting ◽  
Catherine Coughlin ◽  
Yvette Calderon ◽  
...  

BackgroundRecent trends towards more cost-efficient and patient-centred treatment are converging to provide opportunities to improve the care of children. Observation units are hospital areas dedicated to the ongoing evaluation and management of patients for a brief period of time for well-defined conditions. We describe the implementation of a paediatric observation unit (POU) adjacent to a paediatric emergency department (PED) in an urban, academic, community hospital.MethodsStaffing models were designed to provide paediatric services to patients in both the PED and POU. Admission criteria, workflow and transfer guidelines were developed. Quality improvement initiatives were undertaken and evaluated. Unit throughput, patient outcomes and patient satisfaction data were collected and analysed.ResultsOver a 2-year period, there were 24 038 patient visits to the PED. Of these, 1215 (5.1%) patients required admission. Seven hundred and seventy-seven (64.0%) of these children were admitted to the POU. One hundred and nineteen (15.3%) of these patients were subsequently converted to inpatient hospitalisation. The average length of stay (LOS) was 25.7 hours in 2017 and 26.5 hours in 2018. Ten patients returned to the PED within 72 hours of discharge from the POU and four were readmitted. Patient satisfaction scores regarding ‘likelihood to recommend’ improved from the 36th to the 92nd percentile rank over a 1-year period. Close monitoring of patient outcomes allowed for the adjustment of admission guidelines, increased unit census and optimised utilisation.ConclusionA combined PED-POU has been successful at our institution in meeting benchmark goals set for LOS and conversion rates. In addition, quality improvement interventions increased patient census and improved patient satisfaction scores while reducing the inpatient burden on the referring children’s hospital.


2019 ◽  
Vol 3 (3) ◽  
pp. 301-302
Author(s):  
Haridha Sudhakara Pandian ◽  
Priyanka Shivaraman Iyer ◽  
Jasmine Kaur Bhangra ◽  
Aditi Nijhawan

2015 ◽  
Vol 78 (6) ◽  
pp. 360-363 ◽  
Author(s):  
Ching-Kuo Lin ◽  
Mei-Chin Huang ◽  
Yu-Tung Feng ◽  
Wei-Hsuan Jeng ◽  
Te-Cheng Chung ◽  
...  

2001 ◽  
Vol 8 (4) ◽  
pp. 207-211 ◽  
Author(s):  
CY Man

Dologesic is a commonly prescribed analgesic in accident and emergency department. Yet report of overdose with this drug is not common. We report a case in which the patient developed cardiac arrest within an hour of ingestion. Dextropropoxyphene, a component of the drug Dologesic, used to be a common cause of fatalities after drug overdose in the seventies. It is highly toxic in overdose and therefore caution should be exercised when prescribing this drug.


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