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ASSESSMENT OF EFFICACY OF MANUAL COMPRESSION USING END TIDAL CO2 AND RETURN OF SPONTANEOUS CIRCULATION (ROSC) VS NATIONAL BENCHMARKS FOR INPATIENT CARDIAC ARREST

Esmail, Lena Amad
http://rave.ohiolink.edu/etdc/view?acc_num=kent1574689528633685

Abstract Details

2019, DNP, Kent State University, College of Nursing.
The American Heart Association (AHA) is the universal and traditional benchmark for treatment and interventions during cardiac arrest. Quality chest compressions result in a better likelihood of return of spontaneous circulation, also known as ROSC. (Meaney et al., 2013) Currently, the AHA recommends end tidal C02 (ETC02) monitoring to evaluate the quality of compressions(Bhende, Karasic , & Karasic ,1996), however does not require or maintain a national guideline for the tool. The AHA’s guidelines on ETC02 during compressions is >10mmHg.(American Heart Association, 2019) Furthermore, the most recent AHA benchmarks for percent of patients that achieve return of spontaneous circulation (ROSC) is 62.4%, whereas the AHA states that there is a direct relationship with the quality of compressions and ROSC. (Uchenna et al., 2018). Many hospital systems further employ mechanical compression devices as an alternative to manual compressions due to concerns about efficacy of manual compressions. This project aimed to examine the quality of manual compressions across a participating health system using ETC02, which was not currently standard practice within the system, despite having the tools to do so. These values were then compared to the AHA standards to evaluate if the quality was satisfactory. ROSC was also compared to national standards and to their corresponding ETC02 values. Findings from a total of 52 patient samples showed that showed that the mean average ETC02 was 21.12 with a corresponding median 18.5 and standard deviation of 11.49. This is in line with other studies which have shown that end tidal co2 values of >10 mmHG from mechanical compressions. This surpassed the national average. However, there were 21 cases of return of spontaneous circulation accounting for 40.8%, which is less than the national average of 64.2%. Recommendations to add ETC02 monitoring as a standard of care for this hospital system, as well as nationwide were made. In contrast, the efficacy of manual compressions was not found supreme to those of manual compressions, in turn leading to a recommendation not to implement mechanical compression devices to the participating hospital or nationwide.
Lisa Onesko, DNP (Advisor)
Patricia Vermeersch, PhD (Committee Co-Chair)
Wendy Umberger, PhD (Committee Co-Chair)
40 p.
Medicine; Nursing
ROSC, Return of spontaneous circulation, end tidal Co2, ETC02, ETCO2, CPR, compressions, manual compression, mechanical compression

Recommended Citations

Citations

  • Esmail, L. A. (2019). ASSESSMENT OF EFFICACY OF MANUAL COMPRESSION USING END TIDAL CO2 AND RETURN OF SPONTANEOUS CIRCULATION (ROSC) VS NATIONAL BENCHMARKS FOR INPATIENT CARDIAC ARREST [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1574689528633685

    APA Style (7th edition)

  • Esmail, Lena. ASSESSMENT OF EFFICACY OF MANUAL COMPRESSION USING END TIDAL CO2 AND RETURN OF SPONTANEOUS CIRCULATION (ROSC) VS NATIONAL BENCHMARKS FOR INPATIENT CARDIAC ARREST . 2019. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1574689528633685.

    MLA Style (8th edition)

  • Esmail, Lena. "ASSESSMENT OF EFFICACY OF MANUAL COMPRESSION USING END TIDAL CO2 AND RETURN OF SPONTANEOUS CIRCULATION (ROSC) VS NATIONAL BENCHMARKS FOR INPATIENT CARDIAC ARREST ." Doctoral dissertation, Kent State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=kent1574689528633685

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Kent State University and OhioLINK.