Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study

Objective To evaluate the subjective and objective resuscitation performance of emergency medical technicians (EMTs) using mechanical cardiopulmonary resuscitation (MCPR) devices.Design and setting This was a cross-sectional simulation-based study where participants installed the MCPR device on a tr...

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Main Authors: Wen-Chu Chiang, Matthew Huei-Ming Ma, Yu-Chun Chien, Yao-Cheng Wang, Wen-Shuo Yang, Ping Yen, Wei-Chu Chie
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e062908.full
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author Wen-Chu Chiang
Matthew Huei-Ming Ma
Yu-Chun Chien
Yao-Cheng Wang
Wen-Shuo Yang
Ping Yen
Wei-Chu Chie
author_facet Wen-Chu Chiang
Matthew Huei-Ming Ma
Yu-Chun Chien
Yao-Cheng Wang
Wen-Shuo Yang
Ping Yen
Wei-Chu Chie
author_sort Wen-Chu Chiang
collection DOAJ
description Objective To evaluate the subjective and objective resuscitation performance of emergency medical technicians (EMTs) using mechanical cardiopulmonary resuscitation (MCPR) devices.Design and setting This was a cross-sectional simulation-based study where participants installed the MCPR device on a training manikin.Participants We assessed EMT-Intermediates (EMT-Is) and EMT-Paramedics (EMT-Ps) of the Emergency Medical Services (Ambulance) Division of the Taipei City Fire Department.Primary and secondary outcome measures The primary outcome was the gap between self-perceived (subjective) and actual (objective) no-flow time during resuscitation, which we hypothesised as statistically insignificant. The secondary outcome was the association between resuscitation performance and personal attributes like knowledge, attitude and self-confidence.Results Among 210 participants between 21 and 45 years old, only six were female. There were 144 EMT-Is and 66 EMT-Ps. During a simulated resuscitation lasting between four and a half and 5 min, EMTs had longer actual no-flow time compared with self-perceived no-flow time (subjective, 38 s; objective, 57.5 s; p value<0.001). This discrepancy could cause a 6.5% drop of the chest compression fraction in a resuscitation period of 5 min. Among the EMT personal factors, self-confidence was negatively associated with objective MCPR deployment performance (adjusted OR (aOR) 0.66, 95% CI 0.45 to 0.97, p=0.033) and objective teamwork performance (aOR 0.57, 95% CI 0.34 to 0.97, p=0.037) for EMT-Ps, whereas knowledge was positively associated with objective MCPR deployment performance (aOR 2.15, 95% CI 1.31 to 3.52, p=0.002) and objective teamwork performance (aOR 1.77, 95% CI 1.02 to 3.08, p=0.043) for EMT-Is. Moreover, regarding the self-evaluation of no-flow time, both self-satisfaction and self-abasement were associated with objectively poor teamwork performance.Conclusions EMTs’ subjective and objective performance was inconsistent during the MCPR simulation. Self-confidence and knowledge were personal factors associated with MCPR deployment and teamwork performance. Both self-satisfaction and self-abasement were detrimental to teamwork during resuscitation.
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spelling doaj-art-54f884aea984473a8d2353c346fa53b52025-01-28T04:45:14ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2022-062908Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based studyWen-Chu Chiang0Matthew Huei-Ming Ma1Yu-Chun Chien2Yao-Cheng Wang3Wen-Shuo Yang4Ping Yen5Wei-Chu Chie6Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Emergency Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwansection chiefFourth District Headquarters, Taipei City Fire Department, Taipei City, TaiwanparamedicDepartment of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, TaiwanInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, TaiwanObjective To evaluate the subjective and objective resuscitation performance of emergency medical technicians (EMTs) using mechanical cardiopulmonary resuscitation (MCPR) devices.Design and setting This was a cross-sectional simulation-based study where participants installed the MCPR device on a training manikin.Participants We assessed EMT-Intermediates (EMT-Is) and EMT-Paramedics (EMT-Ps) of the Emergency Medical Services (Ambulance) Division of the Taipei City Fire Department.Primary and secondary outcome measures The primary outcome was the gap between self-perceived (subjective) and actual (objective) no-flow time during resuscitation, which we hypothesised as statistically insignificant. The secondary outcome was the association between resuscitation performance and personal attributes like knowledge, attitude and self-confidence.Results Among 210 participants between 21 and 45 years old, only six were female. There were 144 EMT-Is and 66 EMT-Ps. During a simulated resuscitation lasting between four and a half and 5 min, EMTs had longer actual no-flow time compared with self-perceived no-flow time (subjective, 38 s; objective, 57.5 s; p value<0.001). This discrepancy could cause a 6.5% drop of the chest compression fraction in a resuscitation period of 5 min. Among the EMT personal factors, self-confidence was negatively associated with objective MCPR deployment performance (adjusted OR (aOR) 0.66, 95% CI 0.45 to 0.97, p=0.033) and objective teamwork performance (aOR 0.57, 95% CI 0.34 to 0.97, p=0.037) for EMT-Ps, whereas knowledge was positively associated with objective MCPR deployment performance (aOR 2.15, 95% CI 1.31 to 3.52, p=0.002) and objective teamwork performance (aOR 1.77, 95% CI 1.02 to 3.08, p=0.043) for EMT-Is. Moreover, regarding the self-evaluation of no-flow time, both self-satisfaction and self-abasement were associated with objectively poor teamwork performance.Conclusions EMTs’ subjective and objective performance was inconsistent during the MCPR simulation. Self-confidence and knowledge were personal factors associated with MCPR deployment and teamwork performance. Both self-satisfaction and self-abasement were detrimental to teamwork during resuscitation.https://bmjopen.bmj.com/content/12/6/e062908.full
spellingShingle Wen-Chu Chiang
Matthew Huei-Ming Ma
Yu-Chun Chien
Yao-Cheng Wang
Wen-Shuo Yang
Ping Yen
Wei-Chu Chie
Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
BMJ Open
title Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
title_full Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
title_fullStr Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
title_full_unstemmed Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
title_short Objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self-evaluation: a cross-sectional, simulation-based study
title_sort objective performance of emergency medical technicians in the use of mechanical cardiopulmonary resuscitation compared with subjective self evaluation a cross sectional simulation based study
url https://bmjopen.bmj.com/content/12/6/e062908.full
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