Written by Amanda Mathews
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In this video review, information contained in out-of-hospital cardiac arrest (OHCA) patient handoffs was highly variable, which is an area for quality improvement and standardization. Try this checklist!
One voice in the room please
This was a retrospective video review study conducted at a quaternary care Level 1 trauma center that sees approximately 112 cardiac arrests a year. All cardiac arrests occur in resuscitation bays with video and sound recording capabilities, and this hospital already had a quality improvement committee in place to review these cases. They reviewed 95 cardiac arrest resuscitations over a 28-month period. The objective was to evaluate the frequency of communication of key data points by EMS providers and to evaluate the association between data points communicated and time to ED rhythm determination and defibrillation.
Handoffs were initiated in a median of 2 seconds and median handoff length was 66 seconds. Median number of data points communicated was 9/17. Specific variable, such as witnessed arrest, bystander CPR, and end tidal CO2 were communicated in less than half of patients. Initial rhythm was communicated 79% of the time, and defibrillation attempts were reported 58% of the time. The number of points included in a handoff was not associated with the time to ED rhythm check or defibrillation.
How will this change my practice?
There are several key events that need to occur when a patient in cardiac arrest comes into your resuscitation bay, and EMS handoff can get lost in those moving pieces. This article is a good reminder of the types of information to ask for from EMS so you can continue to resuscitate the patient optimally.
Editor’s note: EMS has a lot going on in such cases. Seventeen variables is a lot to remember, especially under stress. Maybe the recorder could call out an EMS handoff checklist, similar to a pre-intubation checklist? Here’s a handy checklist we made for you with all 17 data points. ~Clay Smith
Source
Emergency Medical Services handoff of patients in cardiac arrest in the Emergency Department: A retrospective video review study of duration and details of handoff. Resuscitation. 2023 Aug;189:109834. doi: 10.1016/j.resuscitation.2023.109834. Epub 2023 May 16.
