18
Knowing the unknowns: what we forget in
CPR
S. Donnelly,
1
D. McKendrick,
2
A. Lee
3
and J. Short
2
1
Western Health and Social Care Trust, Altnagelvin
2
Dr Gray’s Hospital, Elgin
3
University of Aberdeen
In hospital, cardiac arrest carries a high mortality rate, with only 13.5% of people surviving to hospital discharge
[1]. It is challenging to provide effective cardiopulmonary resuscitation (CPR) in the highly pressured environ-
ment of a cardiac arrest and there is an observed variation in the quality of CPR provided. This audit assesses
the advanced life support (ALS) knowledge of members of the resuscitation team, looking specifically at recall of
key facts that have been proven to positively affect outcome at cardiac arrest.
Methods
To assess knowledge of ALS, a questionnaire was designed using the Resuscitation Council UK Guidelines 2015.
Individual questions covered facts that had been proven to positively influence outcome at cardiac arrest (early
recognition and call for help, early CPR and early defibrillation). This audit was registered with the local clinical
effectiveness unit as an audit, and the Health Research Authority online toolkit determined that NHS REC
approval was not required.
Members of the resuscitation team at Dr Gray’s Hospital, Elgin, volunteered to complete the questionnaire. After
completion, feedback on responses was given and individuals were provided with correct referenced answers.
Individuals repeated the questionnaire two weeks later to see if there was an improvement in knowledge.
Results
Thirty-eight individuals took part in the initial audit and 24 of these also took part in the repeat audit. The aver-
age questionnaire score improved significantly (p < 0.001) from 63.5% for the initial audit to 83.3% after the
feedback intervention. Initially, key facts such as correct compression depth (34.2%), compression rate (34.2%)
and correct time for rotating the CPR giver (18.4%) were not well recalled. This later improved to 75.0%, 95.8%
and 50.0%, respectively.
Discussion
There was a variation in the ALS knowledge of members of the resuscitation team, where some key facts which
might influence outcome in cardiac arrest were not well recalled. Despite some team members already being
highly trained (valid completion of ALS), they did not initially perform significantly better than others who had
not completed an ALS course. There was a significant improvement in scores after a short knowledge refresher.
Current recommendations from the International Liaison Committee on Resuscitation state that there is improved
learning from low dose, frequent learning events compared to a comprehensive learning event that occurs infre-
quently [2]. Using this approach, frequent assessment could be integrated into the daily work routine of the
resuscitation team to help aid knowledge recall.
References
1. Resuscitation Council (UK). Advanced Life Support. 6th edn. Page 1, The Problem.
2. Hazinski MF, Nolan JP, Aickin R, et al. 2015 International Consensus on Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care Science With Treatment Recommendations. Part 1: Executive Summary, S14,
Basic Life Support Training. http://circ.ahajournals.org/content/132/16_suppl_1/S2
18 © 2017 The Authors. Anaesthesia © 2017 The Association of Anaesthetists of Great Britain and Ireland
Anaesthesia 2017, 72, (Suppl. 2), 10–92 Abstracts