A manikin-based observational study on cardiopulmonary resuscitation skills at the Osaka Senri medical rally.
OBJECTIVE
To examine the current status and problems of resuscitation management in Japan as demonstrated at the 2006 and 2007 Osaka Senri medical rallies.


METHODS
Using manikins, the quality of resuscitation was evaluated in 33 teams that participated in the medical rallies. The challenge was to deliver defibrillation shocks for ventricular fibrillation; data were recorded using the Laerdal PC Skill Reporting System (Norway). The teams were first subjectively (visually) evaluated by a panel of judges and these evaluations were later reaffirmed using video records.


RESULTS
An approximately 30s delay was observed between the time of contact and initiation of chest compression in the teams that adopted the American Heart Association (AHA) method compared with those that adopted the European Resuscitation Council (ERC) method. Although the overall quality of chest compressions was very good, in several instances, the hand positions were inappropriate and complete chest recoil was not achieved. The left paddle was incorrectly positioned by all teams. Only 15.8% of the teams were able to deliver shocks with less than 10s of interruption between the chest compressions. Regarding interruption of chest compressions at confirmation of correct tracheal tube placement, among the eight teams that adopted the AHA method, pauses of more than 10s were confirmed in five (62.5%).


CONCLUSIONS
Significant differences in performance between the AHA and ERC methods were observed. The ERC guidelines were more rational and suitable in terms of actual application than the AHA guidelines.
Kobayashi
Masanao
M
Department of Emergency Medicine, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. emm003@poh.osaka-med.ac.jp
Fujiwara
Akira
A
Morita
Hiroshi
H
Nishimoto
Yasuhisa
Y
Mishima
Takayuki
T
Nitta
Masahiko
M
Hayashi
Toshimasa
T
Hotta
Toshihiro
T
Hayashi
Yasuyuki
Y
Hachisuka
Eisou
E
Sato
Kenji
K
D016887:Cardiopulmonary Resuscitation; D002983:Clinical Competence; D047548:Defibrillators; D004554:Electric Countershock; D006801:Humans; D007564:Japan; D008348:Manikins; D019300:Medical Errors; D008955:Models, Cardiovascular; D011446:Prospective Studies; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000628:therapy*