Time out! Pauses during advanced life support in high-fidelity simulation: A cross-sectional study

Abstract

Background: Prolonged preshock pauses are associated with negative effects on patient outcomes and survival. A greater understanding of these pauses may help to improve the quality of advanced life support (ALS) and clinical outcomes.

Objective: The objective of this study was to identify the pauses that occur during ALS situations in high-fidelity simulation scenarios and the frequency and duration of these pauses.

Methods: One hundred forty-two nursing students participated in this cross-sectional study, involving high-fidelity simulation scenario of cardiorespiratory arrest in a simulated hospital room. Pauses were assessed using an observation checklist.

Results: Students performed the scenario in an average time of 8.32 (standard deviation = 1.13) minutes. Pauses between chest compressions were longer than recommended (mean = 0.36, standard deviation = 1.14). A strong positive correlation was found between the identification of the arrhythmia and the initiation of countershock (rs = 0.613, p < 0.001).

Conclusions: Nursing students generally performed ALS within the time limits recommended by resuscitation guidelines. Early identification of shockable rhythms may lead to early nurse-initiated defibrillation. Strategies to speed up the identification of arrhythmias should be put in place to minimise preshock pauses and improve ALS outcomes.

Keywords: Life support; Nursing; Nursing students; Pauses; Resuscitation; Simulation.