Ward Characteristics Associated with Delayed Defibrillator and Doctor Presence in Cardiopulmonary Resuscitation Simulated Survey

Khemchat  Wangtawesap; Arunotai  Siriussawakul; Onuma  Chaiwat; Tipa  Chakorn; Rapeepan  Nuntabut; Daranee  Kusakunniran; Sudta  Parakkamodom; Panisara  Saengsung; Thanawin  Chawaruechai; Wasinee  Methapraphamorn; Chulaluk  Komoltri

Authors

Khemchat Wangtawesap Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Arunotai Siriussawakul Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Onuma Chaiwat Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Tipa Chakorn CPR Training Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Rapeepan Nuntabut Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Daranee Kusakunniran Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Sudta Parakkamodom Department of Anaesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Panisara Saengsung Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Thanawin Chawaruechai Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Wasinee Methapraphamorn Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
Chulaluk Komoltri Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700

Keywords:

Cardiopulmonary resuscitation; simulation; audit; quality improvement

Abstract

Objective: To survey the times to critical actions (defibrillator and doctor presence, initiation of chest compression) of inhospital
simulated cardiopulmonary resuscitation (CPR).
Methods: A 1-year retrospective simulated audit 2009 in a 2,400-bed university hospital in Thailand.
Results: A total of 57 adult wards (around a third of all wards in the hospital), including intensive care units, critical wards,
procedural units, general wards and out-patient units were audited. Overall, the median time of initiation of chest compression
and defibrillator presence among CPR teams were 1.27 (0.35-7.19) and 1.16 (0.00-26.00) minutes, respectively. The median
time of the first doctor presence was 3.45 (0.00-15.15) minutes. However, there were significant differences in time to defibrillator
and doctor presence among wards. The longer time of these critical managements were recorded in non-monitored areas
(general wards and out-patient units) (p = 0.004 and 0.007, respectively).
Conclusion: In our CPR simulated survey, delayed initiation of critical managements commonly occurred in non-monitored
areas. Better management should be concerned for favorable outcomes.

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