Abstract 115: Video Review and Time-Motion Analysis of the Causes of No-Flow Intervals as Recorded by Accelerometer During Cardiopulmonary Resuscitation

Objectives: Accelerometer (Q-CPR) has been developed and promoted to monitor the quality of cardiopulmonary resuscitation (CPR). Although the device registers the occurrence of no-flow intervals, it does not provide comprehensive information on the causes leading to these no-flow intervals. This study is aimed to analyze causes leading to CPR interruptions registered by Q-CPR by reviewing corresponding video recordings of the resuscitation sessions. Methods: Accelerometer recordings (Q-CPR, Philips) of 20 CPR episodes from December 2010 to April 2014 in a tertiary university ED were obtained. Frequency, timing, duration, and types of no-flow intervals, defined as no-flow duration >= 1.5 seconds, were reviewed. Video recordings of the corresponding CPR sessions were reviewed. Causes leading no flow intervals registered by Q-CPR were categorized and analyzed. Results: The duration of CPR reviewed for the cases averaged 8.59 minutes (range 2.23 - 19.04 minutes). No-flow intervals (pauses >= 1.5 seconds) occurred 122 times (averaged one interruption every 1.27 minutes of CPR) with an average no-flow intervals of 6.45 seconds (range 1.54 - 51.50 seconds). Through detail review of the video-recordings corresponding to the no-flow intervals registered by Q-CPR, the leading causes of no-flow intervals are associated with pulse checks for pulseless electric activity- PEA (19.5%), pre-shock pauses (13.9%), ultrasound exam (11.6%) and intubation (9.6%), as displayed in the following chart. Conclusion: Video recording and time-motion analysis provide detailed information on the causes leading to no-flow intervals registered by QCPR, and could complement information acquired by Q-CPR. Measures should be taken to address leading causes of CPR interruption, especially pulse checks for PEA and pre-shock pauses, to promote quality of CPR.