Quality of Advanced Cardiopulmonary Resuscitation performed by first-year residents in a second level hospital

Abstract

Introduction: Cardiac arrest is an emergency situation that must be resolved quickly and correctly.
Resident physicians rotating into clinical units often face this situation, but there is little opportunity for reflection on the quality of their advanced resuscitation skills in order to identify and correct appropriate areas.

Objective: To evaluate the quality of advanced cardiopulmonary resuscitation (CPR) in adults, provided by first year medical residents who have not had formal training using simulation models.

Method: An observational, cross-sectional, prospective and descriptive study was conducted by assessing 18 first-year medical residents from Agustin O’Horan General Hospital. Five of the residents were from General Surgery, 5 from Obstetrics and Gynaecology, 5 from Internal Medicine, 2 from General Medicine, and 1 from Trauma. None of them had formal training in CPR. All residents were trained in the use of the simulation equipment before their evaluation. This included the correct spot on the mannequin to make compressions, as well as the use of the electrocardiograph and defibrillator. The same case was presented to all residents, which consisted of a patient that had ventricular fibrillation and remained in the same rhythm during all simulations. The advanced cardiopulmonary resuscitation skill was evaluated using the checklists of the American Heart Association.

Results: Ten (56%) of the residents them recognised the problem, 5 (27.7%) gave effective compressions, 3 (17%) recognised and treated a VF, and none of them gave effective ventilations or a quality CPR.

Conclusions: Even though more than half of the residents could identify the rhythm, less than a quarter were able to establish an effective treatment. Because of this, it is necessary to improve CPR teaching with simulation models for medical residents who are in first year of a medical residence.