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Video Case Review for Quality Improvement During Cardiac Arrest Resuscitation in the Emergency Department
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  • Joseph Brooks,
  • Ayal Pierce,
  • Patrick McCarville,
  • Natalie Sullivan,
  • Anahita Rahimi-Saber,
  • Christopher Payette,
  • Margarita Popova,
  • Narou Koizumi,
  • Ali Pourmand,
  • David Yamane
Joseph Brooks
The George Washington University School of Medicine and Health Sciences
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Ayal Pierce
The George Washington University School of Medicine and Health Sciences
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Patrick McCarville
The George Washington University School of Medicine and Health Sciences
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Natalie Sullivan
The George Washington University School of Medicine and Health Sciences
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Anahita Rahimi-Saber
The George Washington University School of Medicine and Health Sciences
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Christopher Payette
The George Washington University School of Medicine and Health Sciences
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Margarita Popova
The George Washington University School of Medicine and Health Sciences
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Narou Koizumi
George Mason University - Arlington Campus
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Ali Pourmand
The George Washington University School of Medicine and Health Sciences
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David Yamane
The George Washington University School of Medicine and Health Sciences
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Abstract

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.

Peer review status:ACCEPTED

24 Mar 2021Submitted to International Journal of Clinical Practice
26 Mar 2021Submission Checks Completed
26 Mar 2021Assigned to Editor
26 Mar 2021Reviewer(s) Assigned
22 Apr 2021Review(s) Completed, Editorial Evaluation Pending
16 May 20211st Revision Received
19 May 2021Submission Checks Completed
19 May 2021Assigned to Editor
19 May 2021Review(s) Completed, Editorial Evaluation Pending
20 May 2021Reviewer(s) Assigned
11 Jun 2021Editorial Decision: Accept