PMID- 34223322 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231107 IS - 2666-5204 (Electronic) IS - 2666-5204 (Linking) VI - 4 DP - 2020 Dec TI - Echocardiography does not prolong peri-shock pause in cardiopulmonary resuscitation using the COACH-RED protocol with non-expert sonographers in simulated cardiac arrest. PG - 100047 LID - 10.1016/j.resplu.2020.100047 [doi] LID - 100047 AB - OBJECTIVE: Focused echocardiography during peri-shock pause (PSP) can prognosticate and detect reversible causes in cardiac arrest but minimising interruptions to chest compressions improves outcome. The COACH-RED protocol was adapted from the COACHED protocol to systematically incorporate echocardiography into rhythm check without prolonging PSP beyond the recommended 10 s. The primary objective of this study was to test the feasibility of emergency nurses learning to perform all roles in the COACH-RED protocol. PSP duration and change in participant confidence were secondary outcomes. METHODS: After an initial two-hour workshop, five ALS-trained nurses were assessed for the correct use of COACH-RED protocol, without critical error, in three simulated cardiac arrest scenarios of four cycles each. Assessments were repeated on days 7 and 35. On day 35, three COACHED scenarios were also assessed for comparison. Participant roles per scenario and cardiac rhythm per cycle were randomised. Participants completed questionnaires on their confidence levels. Sessions were videotaped for accurate measurement of PSP duration and results tabulated for simple comparison. Statistical analysis was not performed due to small sample size. RESULTS: There were no critical errors, two minor team-leading errors and two minor echosonography errors. Minor errors occurred in separate scenarios resulting in a 100% pass rate overall by predetermined criteria. Echocardiographic recordings were 100% adequate. Overall median PSP was 9.35 s for COACH-RED and 6.94 s for COACHED. Sub-group analysis of COACH-RED revealed median PSP 10.80 s in shockable rhythms and 8.74 s ( approximately 2 s less) in non-shockable rhythms. Mean participant confidence in performing COACH-RED improved from 1.6 to 4.6, on a 5-point scale. CONCLUSION: The COACH-RED protocol can be effectively performed by ALS-trained nurses, in all roles of this protocol, including echocardiography, in a simulated environment, after a single training session. Using this protocol, focused echocardiography does not prolong PSP beyond 10 s. CI - (c) 2020 The Author(s). FAU - Taylor, Benjamin AU - Taylor B AD - Emergency Care, Sydney Adventist Hospital, Wahroonga, NSW 2076, Australia. FAU - Joshi, Bhushan AU - Joshi B AD - Emergency Care, Sydney Adventist Hospital, Wahroonga, NSW 2076, Australia. FAU - Hutchison, Leanne AU - Hutchison L AD - Emergency Care, Sydney Adventist Hospital, Wahroonga, NSW 2076, Australia. FAU - Manivel, Vijay AU - Manivel V AD - Emergency Care, Sydney Adventist Hospital, Wahroonga, NSW 2076, Australia. AD - The University of Sydney, Sydney, NSW 2000, Australia. AD - Emergency Department, Nepean Hospital, Kingswood, NSW 2747, Australia. LA - eng PT - Journal Article DEP - 20201127 PL - Netherlands TA - Resusc Plus JT - Resuscitation plus JID - 101774410 PMC - PMC8244492 OTO - NOTNLM OT - ALS, Advanced Life Support OT - ARC, Australian Resuscitation Council OT - Advanced cardiac life support OT - CPR, Cardiopulmonary resuscitation OT - Cardiac arrest OT - Cardiopulmonary resuscitation OT - ED, Emergency Department OT - Echocardiography OT - Education OT - IQR, Interquartile Range OT - Nursing OT - PEA, Pulseless Electrical Activity OT - PSP, Peri-Shock Pause OT - SAH, Sydney Adventist Hospital OT - Simulation training OT - VF, Ventricular Fibrillation OT - VT, Ventricular Tachycardia EDAT- 2021/07/06 06:00 MHDA- 2021/07/06 06:01 PMCR- 2020/11/27 CRDT- 2021/07/05 10:24 PHST- 2021/07/05 10:24 [entrez] PHST- 2021/07/06 06:00 [pubmed] PHST- 2021/07/06 06:01 [medline] PHST- 2020/11/27 00:00 [pmc-release] AID - S2666-5204(20)30047-3 [pii] AID - 100047 [pii] AID - 10.1016/j.resplu.2020.100047 [doi] PST - epublish SO - Resusc Plus. 2020 Nov 27;4:100047. doi: 10.1016/j.resplu.2020.100047. eCollection 2020 Dec.