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1
HypothesisHypothesis
Does the AHA encourage the inadvertent administration of epinephrine 1mg (1:10,000) IV bolus in the treatment of symptomatic bradycardia?
2
MethodsMethods
n= 738
Eighty-two teams of 9
Subjects were selected from students coming in randomly for ACLS Refresher training.
Teams were formed into a control group (n=41) and study group (n=41).
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MethodsMethods
The control group received unaltered AHA crash cart cards to perform their resuscitation practice.
Each team was presented with a scenario of sinus bradycardia with poor perfusion.
Each team was allowed to follow the sinus bradycardia algorithm without interference.
4
MethodsMethods
Team leadership and individual skills were observed using video tape and SimMan event logs printed for each of the sinus bradycardia scenarios.
Each time epinephrine 1mg (1:10,000) was requested, it was documented.
Each time epinephrine 1mg (1:10,000) was administered, it was documented.
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MethodsMethods
The study group received altered AHA crash cart cards to perform their resuscitation practice with epinephrine unbolded.
Each team was presented with a scenario of sinus bradycardia with poor perfusion.
Each team was allowed to follow the sinus bradycardia algorithm without interference.
6
MethodsMethods
Team leadership and individual skills were observed using video tape and SimMan event logs printed for each of the sinus bradycardia scenarios.
Each time epinephrine 1mg (1:10,000) was requested, it was documented.
Each time epinephrine 1mg (1:10,000) was administered, it was documented.
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ResultsResults
In the group using the unaltered algorithm, epi 1mg was requested about 20% of the time and administered to the simulated patient about 10% of the time.
Poster Presentation 2010 IMHS
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ResultsResults
In the study group using the altered algorithm with epinephrine unbolded, it was requested 5%, and administered 2% of the time in the simulated patient.
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ConclusionConclusion
These findings suggest that the current format of the AHA bradycardia algorithm may cause sufficient confusion that the inadvertent administration of IV epinephrine 1mg (1:10,000) may result during treatment of symptomatic bradycardia in a simulated patient.