Physician Compliance With Advanced Cardiac Life Support Guidelines
Study objective: To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians. Design: Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' A...
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| Veröffentlicht in: | Annals of emergency medicine 1995, Vol.25 (1), p.52-57 |
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| creator | Cline, David M Welch, Kenneth J Cline, Lisa S Brown, Charles K |
| description | Study objective: To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians.
Design: Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' ACLS certification.
Setting and participants: All nontraumatic prehospital and hospital cardiac arrests in a rural university hospital.
Results: Two hundred seven arrests were studied for a total of 436 rhythms with a maximum of 4 rhythms per arrest. There were 78 resuscitations (36.3%) with return of spontaneous circulation. A total of 2,038 interventions were recorded for all rhythms, with 1,320 (64.8%) compliant with ACLS guidelines compared with 718 (35.2%) deviations. Synchronized cardioversion, calcium chloride and sodium bicarbonate were used with significantly higher noncompliance. Ventricular fibrillation had significantly higher mean rhythm deviation scores, whereas scores were significantly lower for sinus rhythm and stable bradycardia (
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| doi_str_mv | 10.1016/S0196-0644(95)70355-1 |
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Design: Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' ACLS certification.
Setting and participants: All nontraumatic prehospital and hospital cardiac arrests in a rural university hospital.
Results: Two hundred seven arrests were studied for a total of 436 rhythms with a maximum of 4 rhythms per arrest. There were 78 resuscitations (36.3%) with return of spontaneous circulation. A total of 2,038 interventions were recorded for all rhythms, with 1,320 (64.8%) compliant with ACLS guidelines compared with 718 (35.2%) deviations. Synchronized cardioversion, calcium chloride and sodium bicarbonate were used with significantly higher noncompliance. Ventricular fibrillation had significantly higher mean rhythm deviation scores, whereas scores were significantly lower for sinus rhythm and stable bradycardia (
P<.003). Resuscitations led by ACLS-certified and nonACLS-certified physicians were compared for mean number of deviations per resuscitation attempt, and no differences were found. Resuscitations with return of spontaneous circulation were compared with unsuccessful resuscitations, and there was no difference between groups in controlled deviation scores. No differences could be found between ACLS-certified and nonACLS-certified physicians for return of spontaneous circulation and survival-to-discharge rates.
Conclusion: Despite biannual ACLS training of all medical residents and ICU nurses, noncompliance with ACLS guidelines was noted in 35.2% of treatments. We found no correlation between ACLS certification and ACLS guideline compliance. [Cline DM, Welch KJ, Cline LS, Brown CK: Physician compliance with advanced cardiac life support guidelines.
Ann Emerg Med January 1995;25:52-57.]</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/S0196-0644(95)70355-1</identifier><identifier>PMID: 7802370</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Cardiopulmonary Resuscitation - standards ; Certification ; Electric Countershock ; Emergency Medicine - standards ; Emergency Service, Hospital - standards ; Heart Arrest - therapy ; Humans ; Practice Guidelines as Topic ; Practice Patterns, Physicians ; Retrospective Studies ; United States</subject><ispartof>Annals of emergency medicine, 1995, Vol.25 (1), p.52-57</ispartof><rights>1995 Mosby, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c360t-1ddb3e18889dc5499225d293ed1bcd9c894248abb9b96da0108299f77401e56c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0196064495703551$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,4009,27902,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7802370$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cline, David M</creatorcontrib><creatorcontrib>Welch, Kenneth J</creatorcontrib><creatorcontrib>Cline, Lisa S</creatorcontrib><creatorcontrib>Brown, Charles K</creatorcontrib><title>Physician Compliance With Advanced Cardiac Life Support Guidelines</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>Study objective: To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians.
Design: Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' ACLS certification.
Setting and participants: All nontraumatic prehospital and hospital cardiac arrests in a rural university hospital.
Results: Two hundred seven arrests were studied for a total of 436 rhythms with a maximum of 4 rhythms per arrest. There were 78 resuscitations (36.3%) with return of spontaneous circulation. A total of 2,038 interventions were recorded for all rhythms, with 1,320 (64.8%) compliant with ACLS guidelines compared with 718 (35.2%) deviations. Synchronized cardioversion, calcium chloride and sodium bicarbonate were used with significantly higher noncompliance. Ventricular fibrillation had significantly higher mean rhythm deviation scores, whereas scores were significantly lower for sinus rhythm and stable bradycardia (
P<.003). Resuscitations led by ACLS-certified and nonACLS-certified physicians were compared for mean number of deviations per resuscitation attempt, and no differences were found. Resuscitations with return of spontaneous circulation were compared with unsuccessful resuscitations, and there was no difference between groups in controlled deviation scores. No differences could be found between ACLS-certified and nonACLS-certified physicians for return of spontaneous circulation and survival-to-discharge rates.
Conclusion: Despite biannual ACLS training of all medical residents and ICU nurses, noncompliance with ACLS guidelines was noted in 35.2% of treatments. We found no correlation between ACLS certification and ACLS guideline compliance. [Cline DM, Welch KJ, Cline LS, Brown CK: Physician compliance with advanced cardiac life support guidelines.
Ann Emerg Med January 1995;25:52-57.]</description><subject>Cardiopulmonary Resuscitation - standards</subject><subject>Certification</subject><subject>Electric Countershock</subject><subject>Emergency Medicine - standards</subject><subject>Emergency Service, Hospital - standards</subject><subject>Heart Arrest - therapy</subject><subject>Humans</subject><subject>Practice Guidelines as Topic</subject><subject>Practice Patterns, Physicians</subject><subject>Retrospective Studies</subject><subject>United States</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkFFLwzAQx4Moc04_wqBPog_VS9skzZNo0SkMFKb4GNrkyiLdWpN2sG9vu429-nR33P_uf_cjZErhjgLl9wugkofAk-RGslsBMWMhPSFjClKEXHA4JeOj5JxceP8DADKJ6IiMRApRLGBMnj6WW2-1zddBVq-aqk80Bt-2XQaPZjMUJshyZ2yug7ktMVh0TVO7Nph11mBl1-gvyVmZVx6vDnFCvl6eP7PXcP4-e8se56GOObQhNaaIkaZpKo1miZRRxEwkYzS00EbqtD8tSfOikIXkJgcKaSRlKUQCFBnX8YRc7_c2rv7t0LdqZb3GqsrXWHdeCQEpSyj0QrYXald777BUjbOr3G0VBTWwUzt2agCjJFM7dor2c9ODQVes0BynDrD6_sO-j_2XG4tOeW1xQGQd6laZ2v7j8AeYyH0W</recordid><startdate>1995</startdate><enddate>1995</enddate><creator>Cline, David M</creator><creator>Welch, Kenneth J</creator><creator>Cline, Lisa S</creator><creator>Brown, Charles K</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1995</creationdate><title>Physician Compliance With Advanced Cardiac Life Support Guidelines</title><author>Cline, David M ; Welch, Kenneth J ; Cline, Lisa S ; Brown, Charles K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c360t-1ddb3e18889dc5499225d293ed1bcd9c894248abb9b96da0108299f77401e56c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Cardiopulmonary Resuscitation - standards</topic><topic>Certification</topic><topic>Electric Countershock</topic><topic>Emergency Medicine - standards</topic><topic>Emergency Service, Hospital - standards</topic><topic>Heart Arrest - therapy</topic><topic>Humans</topic><topic>Practice Guidelines as Topic</topic><topic>Practice Patterns, Physicians</topic><topic>Retrospective Studies</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cline, David M</creatorcontrib><creatorcontrib>Welch, Kenneth J</creatorcontrib><creatorcontrib>Cline, Lisa S</creatorcontrib><creatorcontrib>Brown, Charles K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cline, David M</au><au>Welch, Kenneth J</au><au>Cline, Lisa S</au><au>Brown, Charles K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physician Compliance With Advanced Cardiac Life Support Guidelines</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>1995</date><risdate>1995</risdate><volume>25</volume><issue>1</issue><spage>52</spage><epage>57</epage><pages>52-57</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><abstract>Study objective: To determine compliance with advanced cardiac life support (ACLS) guidelines among ACLS-certified and non-ACLS-certified physicians.
Design: Retrospective review of consecutive cardiac arrests between July 1989 and June 1990, including assessment of the resuscitation leaders' ACLS certification.
Setting and participants: All nontraumatic prehospital and hospital cardiac arrests in a rural university hospital.
Results: Two hundred seven arrests were studied for a total of 436 rhythms with a maximum of 4 rhythms per arrest. There were 78 resuscitations (36.3%) with return of spontaneous circulation. A total of 2,038 interventions were recorded for all rhythms, with 1,320 (64.8%) compliant with ACLS guidelines compared with 718 (35.2%) deviations. Synchronized cardioversion, calcium chloride and sodium bicarbonate were used with significantly higher noncompliance. Ventricular fibrillation had significantly higher mean rhythm deviation scores, whereas scores were significantly lower for sinus rhythm and stable bradycardia (
P<.003). Resuscitations led by ACLS-certified and nonACLS-certified physicians were compared for mean number of deviations per resuscitation attempt, and no differences were found. Resuscitations with return of spontaneous circulation were compared with unsuccessful resuscitations, and there was no difference between groups in controlled deviation scores. No differences could be found between ACLS-certified and nonACLS-certified physicians for return of spontaneous circulation and survival-to-discharge rates.
Conclusion: Despite biannual ACLS training of all medical residents and ICU nurses, noncompliance with ACLS guidelines was noted in 35.2% of treatments. We found no correlation between ACLS certification and ACLS guideline compliance. [Cline DM, Welch KJ, Cline LS, Brown CK: Physician compliance with advanced cardiac life support guidelines.
Ann Emerg Med January 1995;25:52-57.]</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>7802370</pmid><doi>10.1016/S0196-0644(95)70355-1</doi><tpages>6</tpages></addata></record> |
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| ispartof | Annals of emergency medicine, 1995, Vol.25 (1), p.52-57 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Cardiopulmonary Resuscitation - standards Certification Electric Countershock Emergency Medicine - standards Emergency Service, Hospital - standards Heart Arrest - therapy Humans Practice Guidelines as Topic Practice Patterns, Physicians Retrospective Studies United States |
| title | Physician Compliance With Advanced Cardiac Life Support Guidelines |
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