title: Cardiopulmonary resuscitation: errors made by pre-hospital emergency medical personnel.
abstract: The purpose of the current study was to evaluate the CPR techniques of emergency healthcare professionals (emergency medical technicians, firemen, emergency first responders, CPR instructors). Skills were evaluated using a Laerdal Skillmeter Manikin, which provided a computerized printout of the quantifiable data during the CPR sequence. All of the 66 subjects in the study had completed a recertification course within the last 2 years (mean = 0.86 +/- 0.18, 95% CI). The sequence was videotaped for later viewing and for correlating the errors with the data. In addition, the participants were required to fill in a questionnaire. The most frequently occurring errors were observed in landmarking, overcompression, palpating a carotid pulse and insufficient ventilation. Although 98.5% of participants made an attempt to landmark their position for compression on the sternum, 35.9% of the total compressions performed by all subjects were incorrectly positioned on the patient's chest. Overcompression of the patient's chest accounted for 55.3% of incorrect compressions. Although 94% of participants attempted to verify a carotid pulse, only 45% were able to feel it and therefore stop performing cardiac massage. Of the total ventilations, 49% were below the American Heart Association (AHA) recommended minimum (800 ml). The results of this study showed a high rate of errors occurring in the CPR provided by emergency healthcare professionals.
authors.affiliation: Montreal General Hospital Trauma Program, Department of Surgery, McGill University, Québec, Canada. liber001@med.mcgill.ca
authors.forename: M
authors.initials: M
authors.lastname: Liberman
authors.forename: A
authors.initials: A
authors.lastname: Lavoie
authors.forename: D
authors.initials: D
authors.lastname: Mulder
authors.forename: J
authors.initials: J
authors.lastname: Sampalis
mesh_terms: D000328:Adult; D002170:Canada; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000193:education; D002983:Clinical Competence; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education; D005069:Evaluation Studies as Topic; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D008297:Male; D008348:Manikins; D019300:Medical Errors; D008875:Middle Aged