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ALERT Presentation:   Randomized trial of continuouscapnography during simulated arrests                       David Kessl...
Background •   Continuous capnography recommended during CPR to help guide therapy     (2010 PALS guidelines- Class IIa LO...
PICO Question • P: In-hospital resuscitation teams • I: A. Use of continuous capnography (CC)      B. CC + education • C: ...
Approach / Design                                            Outcomes:                                 Outcomes:    ETCo2 ...
3 Questions to improve study 1. Should we consider other populations (prehospital    setting, residents, etc?). Is focus o...
Contact Information Name: David Kessler Institution: Columbia E-mail, Phone: drkessler@gmail.com,   516-769-3777 Other Col...
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Randomized Trial of Continuous Capnography during Simulated Arrests

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Dr. David Kessler (Columbia U)

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Randomized Trial of Continuous Capnography during Simulated Arrests

  1. 1. ALERT Presentation: Randomized trial of continuouscapnography during simulated arrests David Kessler Columbia University IMSH 2013: Orlando, Florida / USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. Background • Continuous capnography recommended during CPR to help guide therapy (2010 PALS guidelines- Class IIa LOE C) • Proven benefits: – rise in petco2 precedes clinical recognition of return of spontaneous circulation (ROSC) – 100% sensitive for ROSC • Theoretical benefits: – Improved compressions – Decreased # of pulse checks and pauses (lower no flow fraction) – Avoiding excessive ventilation – Earlier recognition of futile resuscitations International Network for Simulation-based Pediatric Innovation, Research and Education
  3. 3. PICO Question • P: In-hospital resuscitation teams • I: A. Use of continuous capnography (CC) B. CC + education • C: Teams with no CC monitoring available • O: Performance on simulator – Vfib arrest – Primary outcomes: time to recognition of ROSC,no-flow-time fraction, compression quality (depth, ETco2 amount, speed) – Secondary outcomes: timing/# of epinephrine & defibs, # pulse checks, RR International Network for Simulation-based Pediatric Innovation, Research and Education
  4. 4. Approach / Design Outcomes: Outcomes: ETCo2 Time to ROSC Time to ROSC CPR quality CPR quality No flow fraction No flow fraction (RETENTION)ETCo2+education ControlRandomization Simulation 1 Simulation 2 Time = 0 Time = 3 months International Network for Simulation-based Pediatric Innovation, Research and Education
  5. 5. 3 Questions to improve study 1. Should we consider other populations (prehospital setting, residents, etc?). Is focus on team or individual (e.g. leader) 2. What simulator would be best? 3. What/who should be the the focus of the education? 4. What other method of assessment should I use International Network for Simulation-based Pediatric Innovation, Research and Education
  6. 6. Contact Information Name: David Kessler Institution: Columbia E-mail, Phone: drkessler@gmail.com, 516-769-3777 Other Collaborators: Melissa Langhan International Network for Simulation-based Pediatric Innovation, Research and Education

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