Abstract 10412: Duration of Interruptions in Chest Compressions Increases with Increasing Number of Interventions During Cardiac Arrest

Introduction: The American Heart Association recommends limiting chest compression interruptions to ≤10 seconds because prolonged interruptions are detrimental to survival in cardiac arrest. Determining the causes of interruptions is important to structure teams to minimize interruption time. This study sought to determine 1) whether performing more interventions during an interruption increases interruption time and 2) whether the time into the resuscitation in which the interruption occurs affects the duration of the interruption. Hypothesis: We hypothesize that the median duration of an interruption increases as the number of interventions increases and that the median duration of an interruption increases if it occurs later in the resuscitation. Methods: In January 2018 our Emergency Department (ED) began video recording all cardiac arrest resuscitations. These videos are reviewed by a committee of physicians, nurses, technicians, and research staff, and specific data points are confirmed by a physician. The duration of each interruption and cause of each intervention performed during each interruption was recorded. Results: A total of 122 patients with 798 chest compression interruptions from January 2018 to December 2020 were included in our analysis. Median age was 78 years and 44% were female. The median duration of interruptions was 13 seconds (interquartile range [IQR]: 10, 18) when no interventions were performed, 12 seconds (IQR: 8, 18) with 1 intervention, 17 seconds (IQR: 12, 26) with 2 interventions, and 19 seconds (IQR: 13, 24) with 3 or 4 interventions (p<0.0001). The median duration of interruptions was 14 seconds (IQR: 10, 22) in the first quartile of resuscitation length, 14 seconds (IQR: 10, 20) in quartile 2, 14 seconds (IQR: 10, 24) in quartile 3, and 11 seconds (IQR: 8, 18) in quartile 4 (p=0.0058). Conclusions: Our findings demonstrate that the median duration of chest compression interruptions increases as the number of interventions performed during that interruption increases. Additionally, interruption duration was shortest when the interruption was performed later in the resuscitation. These findings suggest that interruptions in chest compressions can be minimized by performing fewer tasks during the interruption.

The plasticity of well-being: A training-based framework for the cultivation of human flourishing

Research indicates that core dimensions of psychological well-being can be cultivated through intentional mental training. Despite growing research in this area and an increasing number of interventions designed to improve psychological well-being, the field lacks a unifying framework that clarifies the dimensions of human flourishing that can be cultivated. Here, we integrate evidence from well-being research, cognitive and affective neuroscience, and clinical psychology to highlight four core dimensions of well-being—awareness, connection, insight, and purpose. We discuss the importance of each dimension for psychological well-being, identify mechanisms that underlie their cultivation, and present evidence of their neural and psychological plasticity. This synthesis highlights key insights, as well as important gaps, in the scientific understanding of well-being and how it may be cultivated, thus highlighting future research directions.

Physical activity programs for elderly persons: an evaluation of Brazilian scientific production using the RE-AIM framework

The RE-AIM framework is a model that analyzes both the external and internal validity of health programs. It proposes that programs should be evaluated based on five key dimensions: reach, effectiveness/efficiency, adoption, implementation and maintenance. The aim of the present study was to conduct a systematic review of physical activity programs for elderly persons published in Brazilian scientific literature using the RE-AIM framework. A total of 26 articles included in four scientific databases from 1993 to 2013 were identified and coded using a validated 52-item RE-AIM abstraction tool. Using the RE-AIM dimensions, indicators of reach (47.2%), effectiveness (36.3%), and implementation (27.5%) were reported more often than indicators of adoption (6.4%) and maintenance (4.7%). Only two articles were included in all five RE-AIM dimensions. Despite the increasing number of interventions targeting the elderly, few address the dimensions proposed by the RE-AIM framework, reducing their potential generalizability outside their original settings, and their overall external validity.