CPR QUALITY

IMPROVING CARDIAC
R E S U S C I TAT I O N O U T C O M E B O T H
I N S I D E A N D O U T S I D E T H E H O S P I TA L
Lecturer: Abdurahman Wahid
F O U R A R E A S R E L AT E D T O C P R Q U A L I T Y

METRICS OF
TEAM LEVEL
CPR
LOGISTICS
PERFORMANCE

HIGH
QUALITY
CPR

MONITORING
AND CQI
FEEDBACK
METRIC OF CPR PERFORMANCE

Indicator Measurement

Proportion Of Compression During

Chest Compression Fraction ( C C F) > 80 % Cardiacc Arrest

At Least 30 Compression
Chest Compression Rate 100 - 120 X / Min During18 S

Depth At Least 50 Mm (Adults) And 1/3 A P At Least 27 Adequat Depth In

Dimension In Children And Infant 30 Compression

At Least 27 Adequat Depth In

Full Chest Recoil 30 Compression

Avoid Excessive Ventilation: Rate < 12 X / Min Minimal Chest Rise

MONITORING AND FEEDBACK:
O P T I O N S A N D T E C H N I Q U E S F O R M O N I T O R I N G PAT I E N T S
RESPONSES

Indicators Measurement

Coronary Perfusion Pressure (C P P) > 20 Mmhg

(Invasive) Diastolic Pressure - C V P

Arterial Line Only: Arterial Diastolic Pressure > 25

Monitor
Mmhg

Capnography Only: Et C O2 > 20 Mmhg Monitor

I F Y O U D O N ’ T M E A S U R E I T, Y O U C A N ’ T I M P R O V E I T
AED MONITOR WITH FEEDBACK
T E A M L E V E L L O G I S T I C S : W H AT D O Y O U
H AV E T O E N S U R E H I G H Q U A L I T Y C P R ?
MAXIMIZE CCF
CHOREOGRAPH TEAM
ACTIVITIES MINIMIZE
PERISHOCK TIMES

A I R W AY P L A C E M E N T

ENSURE A FIRM, HARD BACKBOARD SHOULD

S U R FA C E B E I N S TA L L E D I N < 3 S

MECHANICAL COMPRESSION AUTOPULSE

LOGISTIC DEVICES

autopulse

Extra Corporeal Membran

Oxygenation

Backboard
E F F E C T I V E C O M M U N I C AT I O N I N
R E S U S C I TAT I O N T E A M
Elements Leader Role Team Members

Assign Task After Oral Inform The Leader When A Task

Closed Loop Communication
Clear Messages
Clear Roles And Responsibility
Knowing One’s Limitation
Confirmation Begin Or Ends
Encourage Team Member To Repeat Medication Order
Speak Clearly Question And Answer
Perform Task Approriate To
Define All Member Roles
Level Of Competence
1.
Call For Assistance And Seek Advice From Experienced Personnel

Ask For Good Ideas For Share Information With Other

Kknowledge Sharing
Constructive Intervention
Reevaluation And Summarizing
Mutual Respest
Differential Dx
Ask That A Different Intervention
Be Started
Review Or Maintain An Ongoing
Record Of Drug And Treatment
1. Non Aggressive Gesture
2. Ackowledge Correctly For Completed
Assignment
3.
Team
Suggest An Alternative Drug In
Confident Manner
Draw Attention To Significant
Changes In Clinical Condition
1. Avoid Displaying Aggression
2. Speak In Friendly
S U G G E S T E D L O C AT I O N S O F
R E S U S C I TAT I O N T E A M

A I R W AY

COMPRESSOR IV / IO MEDS

MONITOR /
RECORDER D E F I B R I L L L AT O R

TEAM
LEADER
CONTROL QUALITY
INSURANCE (CQI)

PERFORMANCE

• Review of quality and

performace of CPR after
cardiac arrest E V A L U AT I O N OUTCOME

• Goal: improve outcome

DEBRIEFING
INPUT FOR CQI

dynamic team role Metric Performance

Post Resuscitation Checklist

question ??