Using Metrics to Improve ILS Performance in FREC 4 Students.

Yesterday we were working with our FREC 4 students on resuscitation. Here they are working a simulated cardiac arrest in a nightclub. They were working on their teamwork and communication skills in a low light noisy environment.

Prior to the simulation we worked on their ILS skills. As you can see having not practiced for over a month this was their result of their first attempt as a team. After 10 minutes and 39 seconds they had performed 847 total compressions at an average rate of 113 compressions per minute hitting the 100-120 compressions a minute 69% of the total time. Their average compression depth was 5.6 cm making between 5-6cm 89% of the time. What we did see is that they were not releasing compressions (resting on the chest) 74% of the time. This would have profound effects on patient outcome. Hand position on the chest was correct 96% of the time. The chest compression fraction (time on the chest) was 73%. Ventilating the manikin had an average tidal volume on 900 mL (far too high and detrimental to patient outcome) with an average of 0.6 seconds per ventilation. They were able to ventilate the correct tidal volume only 20% of the time. After the first attempt the students debriefed immediately, reviewed their performance analysed their team performance, individual performance and immediately worked on improvement goals.

"Prior studies demonstrate that visual assessment of CPR quality is neither reliable nor accurate, making it challenging for instructors to provide consistently meaningful feedback during CPR training." AHA Resuscitation Education Science October 2020.

After 30 minutes of practice the same group of students went through the ILS scenario again. As you can see below their performance dramatically improved in every metric. CCF increased to 84%, compressions and ventilations improved dramatically. They could see their improvement and it was infectious. If we had been able to spend any more time on their ILS their performance would have improved even more. These students came in an extra day as they were not satisfied with their own performance. We at EMTG applaud their professional attitude and willingness to go the extra mile.

Measured performance motivates learners.

At EMTG we provide high quality instruction and training. If you are not receiving this level of training you might want to ask why. If you are serious about your EMS training give us a call or drop us an email because in the end it's all about caring for the patient.

We teach the basics right so that everything that comes after has a solid foundation.

"Poor quality CPR is a preventable harm." AHA Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest.

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