CPR-induced consciousness

A cross-sectional study of healthcare practitioners' experience

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Introduction: Consciousness may occur during effective management of cardiac arrest and ranges from eye opening to interfering with rescuers’ resuscitation attempts. Reported cases in the medical literature appear scant compared to anecdotal reports. The aim of this study was to evaluate health care providers’ experience with consciousness during cardio-pulmonary resuscitation (CPR).

Methods: A cross-sectional survey of 100 experienced health care professionals, including doctors, nurses and paramedics. Participants were asked about their experience with both CPR-non-interfering consciousness (e.g. eye opening, agonal breaths or mild restlessness) and CPR-interfering consciousness (e.g.purposeful movement, withdrawing from CPR, attempting to pull out airway-securing devices).

Results: A third of responders reported attending more than 100 cases of arrests, while another third had attended 20 or less arrests. The responders had a mean of 11 (SD 8.7) years of practice. Most responders (59 of 67) to the question had experienced CPR-non-interfering consciousness and reported experienc-ing it a median of 3 (IQR 1–5) times. CPR-interfering consciousness had been experienced by 51 of the 63 responders and was experienced overall 1 (IQR 1–3) time. Management of these cases varied widely with varied opinion on ideal management ranging from no action to sedation and/or paralysis. A guide-line describing the management of this presentation was considered necessary by 40 out of 57 (70%)responders.

Conclusions: Contrasting to a few reports in the medical literature, CPR-induced consciousness appears to be experienced more commonly during resuscitation. Management strategies varied widely and clinician opinion of ideal management was also varied. The desire for consensus guidelines on this topic exists. Acute care nurses are integral members of all resuscitation teams and in conjunction with other clinicians, ideally placed to develop, implement and disseminate such guidelines to delivering evidence based care to this sub-group of patients.
Original languageEnglish
Pages (from-to)186-190
Number of pages5
JournalAustralasian Emergency Nursing Journal
Volume19
Issue number4
DOIs
Publication statusPublished - 1 Nov 2016

Keywords

  • Emergency medicine
  • Resuscitation
  • Cardiopulmonary resuscitation
  • Heart arrest
  • Consciousness
  • Surveys and questionnaires

Cite this

@article{83e9c68aa9fd4b868ff66f5e5365d9b2,
title = "CPR-induced consciousness: A cross-sectional study of healthcare practitioners' experience",
abstract = "Introduction: Consciousness may occur during effective management of cardiac arrest and ranges from eye opening to interfering with rescuers’ resuscitation attempts. Reported cases in the medical literature appear scant compared to anecdotal reports. The aim of this study was to evaluate health care providers’ experience with consciousness during cardio-pulmonary resuscitation (CPR).Methods: A cross-sectional survey of 100 experienced health care professionals, including doctors, nurses and paramedics. Participants were asked about their experience with both CPR-non-interfering consciousness (e.g. eye opening, agonal breaths or mild restlessness) and CPR-interfering consciousness (e.g.purposeful movement, withdrawing from CPR, attempting to pull out airway-securing devices).Results: A third of responders reported attending more than 100 cases of arrests, while another third had attended 20 or less arrests. The responders had a mean of 11 (SD 8.7) years of practice. Most responders (59 of 67) to the question had experienced CPR-non-interfering consciousness and reported experienc-ing it a median of 3 (IQR 1–5) times. CPR-interfering consciousness had been experienced by 51 of the 63 responders and was experienced overall 1 (IQR 1–3) time. Management of these cases varied widely with varied opinion on ideal management ranging from no action to sedation and/or paralysis. A guide-line describing the management of this presentation was considered necessary by 40 out of 57 (70{\%})responders.Conclusions: Contrasting to a few reports in the medical literature, CPR-induced consciousness appears to be experienced more commonly during resuscitation. Management strategies varied widely and clinician opinion of ideal management was also varied. The desire for consensus guidelines on this topic exists. Acute care nurses are integral members of all resuscitation teams and in conjunction with other clinicians, ideally placed to develop, implement and disseminate such guidelines to delivering evidence based care to this sub-group of patients.",
keywords = "Emergency medicine, Resuscitation, Cardiopulmonary resuscitation, Heart arrest, Consciousness, Surveys and questionnaires",
author = "Alexander Olaussen and Matthew Shepherd and Ziad Nehme and Karen Smith and Jennings, {Paul A} and Stephen Bernard and Biswadev Mitra",
year = "2016",
month = "11",
day = "1",
doi = "10.1016/j.aenj.2016.07.002",
language = "English",
volume = "19",
pages = "186--190",
journal = "Australasian Emergency Nursing Journal",
issn = "1574-6267",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - CPR-induced consciousness

T2 - A cross-sectional study of healthcare practitioners' experience

AU - Olaussen, Alexander

AU - Shepherd, Matthew

AU - Nehme, Ziad

AU - Smith, Karen

AU - Jennings, Paul A

AU - Bernard, Stephen

AU - Mitra, Biswadev

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Introduction: Consciousness may occur during effective management of cardiac arrest and ranges from eye opening to interfering with rescuers’ resuscitation attempts. Reported cases in the medical literature appear scant compared to anecdotal reports. The aim of this study was to evaluate health care providers’ experience with consciousness during cardio-pulmonary resuscitation (CPR).Methods: A cross-sectional survey of 100 experienced health care professionals, including doctors, nurses and paramedics. Participants were asked about their experience with both CPR-non-interfering consciousness (e.g. eye opening, agonal breaths or mild restlessness) and CPR-interfering consciousness (e.g.purposeful movement, withdrawing from CPR, attempting to pull out airway-securing devices).Results: A third of responders reported attending more than 100 cases of arrests, while another third had attended 20 or less arrests. The responders had a mean of 11 (SD 8.7) years of practice. Most responders (59 of 67) to the question had experienced CPR-non-interfering consciousness and reported experienc-ing it a median of 3 (IQR 1–5) times. CPR-interfering consciousness had been experienced by 51 of the 63 responders and was experienced overall 1 (IQR 1–3) time. Management of these cases varied widely with varied opinion on ideal management ranging from no action to sedation and/or paralysis. A guide-line describing the management of this presentation was considered necessary by 40 out of 57 (70%)responders.Conclusions: Contrasting to a few reports in the medical literature, CPR-induced consciousness appears to be experienced more commonly during resuscitation. Management strategies varied widely and clinician opinion of ideal management was also varied. The desire for consensus guidelines on this topic exists. Acute care nurses are integral members of all resuscitation teams and in conjunction with other clinicians, ideally placed to develop, implement and disseminate such guidelines to delivering evidence based care to this sub-group of patients.

AB - Introduction: Consciousness may occur during effective management of cardiac arrest and ranges from eye opening to interfering with rescuers’ resuscitation attempts. Reported cases in the medical literature appear scant compared to anecdotal reports. The aim of this study was to evaluate health care providers’ experience with consciousness during cardio-pulmonary resuscitation (CPR).Methods: A cross-sectional survey of 100 experienced health care professionals, including doctors, nurses and paramedics. Participants were asked about their experience with both CPR-non-interfering consciousness (e.g. eye opening, agonal breaths or mild restlessness) and CPR-interfering consciousness (e.g.purposeful movement, withdrawing from CPR, attempting to pull out airway-securing devices).Results: A third of responders reported attending more than 100 cases of arrests, while another third had attended 20 or less arrests. The responders had a mean of 11 (SD 8.7) years of practice. Most responders (59 of 67) to the question had experienced CPR-non-interfering consciousness and reported experienc-ing it a median of 3 (IQR 1–5) times. CPR-interfering consciousness had been experienced by 51 of the 63 responders and was experienced overall 1 (IQR 1–3) time. Management of these cases varied widely with varied opinion on ideal management ranging from no action to sedation and/or paralysis. A guide-line describing the management of this presentation was considered necessary by 40 out of 57 (70%)responders.Conclusions: Contrasting to a few reports in the medical literature, CPR-induced consciousness appears to be experienced more commonly during resuscitation. Management strategies varied widely and clinician opinion of ideal management was also varied. The desire for consensus guidelines on this topic exists. Acute care nurses are integral members of all resuscitation teams and in conjunction with other clinicians, ideally placed to develop, implement and disseminate such guidelines to delivering evidence based care to this sub-group of patients.

KW - Emergency medicine

KW - Resuscitation

KW - Cardiopulmonary resuscitation

KW - Heart arrest

KW - Consciousness

KW - Surveys and questionnaires

U2 - 10.1016/j.aenj.2016.07.002

DO - 10.1016/j.aenj.2016.07.002

M3 - Article

VL - 19

SP - 186

EP - 190

JO - Australasian Emergency Nursing Journal

JF - Australasian Emergency Nursing Journal

SN - 1574-6267

IS - 4

ER -