Abstract 130: Mechanical, Team-focused, Video-Reviewed Cardiopulmonary Resuscitation Improves Trends in Survival to Discharge and Cardiac Arrest Performance Measures
Background: Our previous research demonstrated an improvement in ROSC after implementing a bundle including mechanical, team-focused, video-reviewed cardiopulmonary resuscitation (MTV-CPR) for cardiac arrest patients in our ED. The aims of this study are to assess trends in cardiac arrest outcomes and improvements in cardiac arrest performance measures after the implementation of our MTV-CPR intervention. Methods: In 2018, our ED began using mechanical CPR; a new team-focused strategy with nurse led ACLS; and biweekly video-review of cardiac arrests. The primary outcome of this study was to evaluate the annual trend in survival to discharge from 2017 (the year before implementing MTV-CPR) through 2019. Secondary outcomes included ROSC and survival to admission. The Cochrane-Armitage test was used to evaluate annual trends in outcomes over the 3-year study period. We also sought to determine if an improvement in cardiac arrest performance measures occurred over the two years of our MTV-CPR intervention using Wilcoxon rank sum and two-sample t-tests. Cardiac arrest performance measures are listed in the table. Results: The groups were similar at baseline over the 3-year study period. 291 patients were included in the study (96 in 2017, 96 in 2018, and 99 in 2019). Survival to discharge improved from 3.1% in 2017 to 5.2% in 2018 to 10.1% in 2019 (p= 0.043); ROSC improved from 26% to 41.7% to 40.4% (p=0.038); survival to admission went from 19.8% to 25% to 29.3% but was not significantly different (p=0.124). Results for cardiac arrest performance measures are reported in the table. There were significant reductions in time to bed transfer, rhythm determination, mechanical CPR placement, and duration of each chest compression interruption due to ultrasound. Conclusions: Implementation of our MTV-CPR intervention for cardiac arrest patients resulted in improved trends in survival to discharge and ROSC, as well as improvements in multiple cardiac arrest performance measures.