Abstract 19395: Variation Between Intended and Actual Delivery of Ventilatory Parameters During CPR

BackgroundIt has been shown that healthcare providers (HCP) often perform ventilations outside of recommended guidelines during resuscitation. Data suggest that cardiac arrest survival is sensitive to ventilation quality.ObjectiveTo assess the variation between actual HCP ventilation parameters provided to patients during resuscitation compared with both guidelines and HCP perceptions of delivered care.Design/MethodsWe performed an observational study which captured time synchronized respiratory data from adult resuscitation events at 2 sites between 02/2015-04/2016 using a respiratory profile monitor (Philips Respironics NM3). Respiratory Rate (RR) and Tidal Volume (TV) were analyzed. HCP were asked to estimate the RR and TV delivered. RR and TV were averaged per min over the course of the event and then compared to the reported perceived care and Guideline recommendations.ResultsTen cardiac arrest events (59%) had surveys completed by HCP; 596 average respiratory data points by minute were analyzed. All HCP who performed ventilations were self-reported as Respiratory Therapists. Actual mean RR was 21.9±7.3 breaths per min (bpm) with a range of 1-32 bpm and mean TV was 536.2±181.5 ml with a range of 216-4000 ml. Of the 10 events, 3 (30%) of the HCP delivered an actual RR ±5 bpm different than their intended rate, 5 (50%) delivered a RR ±5 bpm different than Guideline recommendations (Figure A, B); 6 (60%) of HCP delivered a TV of ±200 ml different than intended, 3 (30%) delivered a TV ±200 ml different than Guidelines (Figure C, D).ConclusionsHCP RR was consistent with perceived care but inconsistent with Guideline recommendations. TV varied greatly and was inconsistent with perceived care; though TV delivery fell close to Guideline recommendations the range was wide.