Cardiopulmonary resuscitation performance during simulator-based trainings: A comparative retrospective analysis of adherence to 2005 and 2010 guidelines

Background. New cardiopulmonary resuscitation (CPR) guidelines have been published in 2010 emphasizing the importance of minimizing interruptions during chest compression. The aim of our study was to compare the simulator-based CPR training performance of physicians not specialized in anaesthesia and intensive care nurses before and after implementation of new resuscitation guidelines. Methods. In autumn 2010, a total of 74 scenarios during six 1.5 day simulation-based CPR trainings were performed. Four of them were conducted after the implementation of the 2010 guidelines. During each simulated scenario a programmed script standardized the conditions of the simulator and its reactions on the trainees' actions. CPR relevant parameters were extracted on the basis of the simulator's log files and no-flow-time fraction and median cardiac output of the simulator were calculated. Results before and after the guideline implementation were compared using the Wilcoxon Two Sample Test. Results. Thirty-four out of 74 scenarios were included into the analysis. During training according to the 2010 guidelines, the no-flow-time fraction was lower (median: 21.8% [IQR: 16.1-27.1%] vs. 29.1% [IQR: 25.0-30.9%]; P=0.04). The median cardiac output increased from 1.60 L/min^-1 [IQR: 1.50-1.65 L/min ^-1] to 1.90 L/min^-1 [IQR: 1.80-2.10 L/min^-1]; P<0.001) when the CPR training was conducted according to the 2010 resuscitation guidelines. Conclusion. Non-anesthesiological physicians and intensive care nurses training demonstrated an improved CPR performance in a high-fidelity human patient simulator with respect to the median cardiac output and duration of no-flow-time when 2010 CPR guidelines were applied.