title: Cardiopulmonary resuscitation performance during simulator-based trainings: a comparative retrospective analysis of adherence to 2005 and 2010 guidelines.
abstract: BACKGROUND
  New cardiopulmonary resuscitation (CPR) guidelines have been published in 2010 emphasizing the importance of minimizing interruptions during chest compression. The aim of our study was to compare the simulator-based CPR training performance of physicians not specialized in anaesthesia and intensive care nurses before and after implementation of new resuscitation guidelines.
  
  
  METHODS
  In autumn 2010, a total of 74 scenarios during six 1.5 day simulation-based CPR trainings were performed. Four of them were conducted after the implementation of the 2010 guidelines. During each simulated scenario a programmed script standardized the conditions of the simulator and its reactions on the trainees' actions. CPR relevant parameters were extracted on the basis of the simulator's log files and no-flow-time fraction and median cardiac output of the simulator were calculated. Results before and after the guideline implementation were compared using the Wilcoxon Two Sample Test.
  
  
  RESULTS
  Thirty-four out of 74 scenarios were included into the analysis. During training according to the 2010 guidelines, the no-flow-time fraction was lower (median: 21.8% [IQR: 16.1-27.1%] vs. 29.1 % [IQR: 25.0-30.9 %]; P=0.04). The median cardiac output increased from 1.60 L/min-1 [IQR: 1.50-1.65 L/min-1] to 1.90 L/min-1 [IQR: 1.80-2.10 L/min-1]; P<0.001) when the CPR training was conducted according to the 2010 resuscitation guidelines.
  
  
  CONCLUSIONS
  Non-anesthesiological physicians and intensive care nurses training demonstrated an improved CPR performance in a high-fidelity human patient simulator with respect to the median cardiac output and duration of no-flow-time when 2010 CPR guidelines were applied.
authors.affiliation: Department of Anesthesiology, Klinikum rechts der Isar, Technische Universität München, München, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Mayer
authors.forename: C M
authors.initials: CM
authors.lastname: Schulz
authors.forename: M
authors.initials: M
authors.lastname: Kreuzer
authors.forename: K J
authors.initials: KJ
authors.lastname: Wagner
authors.forename: G
authors.initials: G
authors.lastname: Schneider
authors.forename: E F
authors.initials: EF
authors.lastname: Kochs
mesh_terms: D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000706:statistics & numerical data* / Q000639:trends; D003627:Data Interpretation, Statistical; D004554:Electric Countershock; D005060:Europe; D019983:Guideline Adherence / Q000706:statistics & numerical data* / Q000639:trends*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016544:Patient Simulation; D012189:Retrospective Studies