332 Original article Cardiopulmonary resuscitation surprise drills for assessing, improving and maintaining cardiopulmonary resuscitation skills of hospital personnel Raymond Farah a , Eva Stiner b , Zmora Zohar b , Fabio Zveibil c and Arie Eisenman b Background Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel trained in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. Western Galilee Hospital has developed simulator programs for surprise CPR training exercises in all hospital departments and units. This study assessed the efficacy of surprise drills. Methods Advanced cardiac life-support instructors performed 131 surprise drills between 2003 and 2005, using a computerized simulation mannequin (SIM 4000). Nine criteria were measured and scored in the drill: reaction time, CPR according to ABC principles, calling for doctor, CPR knowledge, CPR skills, resuscitation management, staff work, resuscitation chart, and defibrillator management. Drills were evaluated, discussed, and compared with previous drills from the same department and from other departments. Results A gradual improvement was observed in the results of the drills held through 2003–2005, more significantly in the medical departments than in the surgical departments and outpatient clinics. The average score in 2005 was 77.2% (P = 0.001), compared with 74% (P = 0.012) in 2004 and 59% (P < 0.001) in 2003. Major improved criteria were calling for doctor, staff work, CPR knowledge, and defibrillator (P < 0.05). Conclusion It is our belief that surprise resuscitation drills constitute an effective tool to improve performance in case of a real emergency resuscitation, both on a departmental and a general hospital level. European Journal of Emergency Medicine 14:332–336  c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Emergency Medicine 2007, 14:332–336 Keywords: CPR training, resuscitation, surprise drills Departments of a Internal Medicine F, b Emergency Medicine and c Intensive Care Unit, Western Galilee Hospital, Nahariya, Israel Correspondence to Raymond Farah, MD, Department of Internal Medicine F, Western Galilee Hospital, PO Box 21, Nahariya 22100, Israel Tel: +972 4 9107520; fax: +972 4 9107482; e-mail: Raymond.Farah@naharia.health.gov.il Received 22 March 2007 Accepted 9 May 2007 Introduction Sophisticated medical devices or big oxygen tanks are not always necessary for saving a life. Two hands and basic knowledge of cardiopulmonary resuscitation (CPR) are enough to sustain the heart and brain of an ailing person for a short period. CPR is a sudden, emergency procedure that requires a rapid and efficient response, available equipment, and personnel trained in lifesaving proce- dures. Opening an airway, resuscitating, helping a heart that fails for a moment, and calling for help, can be performed by a qualified staff member. As the time component is crucial for saving a patient’s life, it is important that medical personnel master and internalize the skills of life-saving procedures. New methods and guidelines for CPR have been developed over the last few years, and many practitioners in all sectors of the medical and nursing professions are neither knowledgeable nor skilled enough [1–3]. There is a need for regular practice and training. Western Galilee Hospital is the first and only institution in Israel that has developed simulator programs for surprise CPR training in all hospital departments, units, and clinics. The aim of this study was to assess the efficacy of these surprise drills and assess whether they improved the quality of resuscitation and the ability of personnel in the hospital’s various departments to utilize basic life support (BLS), advanced cardiac life support (ACLS) and to perform CPR. Methods A team of 22 qualified ACLS resuscitation instructors carried out 131 CPR drills in 30 different clinical departments and units during the years 2003–2005 at Western Galilee Hospital, Nahariya. Two resuscitation instructors, a doctor and a nurse conducted the surprise drills, using a computerized simulation mannequin (SIM 4000) [4]. They presented a clinical scenario, observed, and documented their findings. The scenario described a clinical case of sudden cardiac arrest including the various fatal arrhythmias according to the ACLS protocols. The 0969-9546  c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.