Basics in advanced life support: a role for download audit and metronomes.
An intention in 2003 to undertake a multicentre trial in the United Kingdom of compressions before and after defibrillation could not be realized because of concerns at the time in relation to informed consent. Instead, the new protocol was introduced in one ambulance service, ahead of the 2005 Guidelines, with greater emphasis on compressions. The results were monitored by analysis of electronic ECG downloads. Deficiencies in the standard of basic life support were identified but were not unique to our service. The introduction of metronomes and the provision of feedback to crews led to major improvements in performance. Our experience has implications for the emergency pre-hospital care of cardiac arrest.
Fletcher
David
D
South East Coast Ambulance Trust, 40-42 Friars Walk, Lewes BN7 2XW, East Sussex, United Kingdom.
Galloway
Robert
R
Chamberlain
Douglas
D
Pateman
Jane
J
Bryant
Geoffrey
G
Newcombe
Robert G
RG
D022561:Advanced Cardiac Life Support / Q000379:methods* / Q000592:standards; D000552:Ambulances; D016009:Chi-Square Distribution; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006336:Heart Massage; D006801:Humans; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D006113:United Kingdom