In television dramas, CPR is often successful. The nurse or doctor is able to resuscitate lifeless body within minutes, simply by pushing on their chest. Unfortunately, in the real world, less than 20 percent of people who receive CPR in a hospital actually survive.
This year, Texas Health Resources and the American Heart Association (AHA) are working together to try an innovative new approach to CPR training. They’re not changing the guidelines to how CPR is performed, but how, and when health providers practice performing.
Although the latest AHA Guidelines for CPR were released in 2010 — recommending chest compressions before starting traditional mouth-to-mouth resuscitation — the model for training and re-certifying nurses and other health care providers to perform CPR has been the same for decades.
Once every two years, you go into a classroom with a few dozen people, watch a video and listen to a lecture.
“You pretty much memorize the answers and you pretty much memorize what you’re supposed to do,” says Dede Scholl, manager of the Special Care Nursery at Texas Health Presbyterian Hospital in Dallas.
The training can be tedious, easy to forget in a year if you’re not regularly performing it, and since you’re practicing on an inanimate plastic dummy there’s no way to be sure you’re performing CPR correctly.
That’s where the high-tech torso comes in.
The Mobile Simulation Station
AHA Training Center Coordinator & Clinical Educator, Texas Health Presbyterian Hospital Dallas
Officially called The Mobile Simulation Station, the training device is a mannequin paired with a laptop and built in speakers developed through an alliance between the AHA and Laerdal Medical. It serves both as patient and coach during CPR training.
Real Time Feedback, From A Smart Dummy
After a short instructional video plays on the laptop perched above the mannequin, it instructs Klackman to begin CPR by placing the heel of one hand in the center of the mannequin’s chest. She places the other on top, straightens her arms, and begins sixty chest compressions at a rate of about 100 per minute.
If she slows down, the machine tells her to speed up. If she presses too hard or too deep (two inches is ideal), it tells her to back off. If she is performing CPR correctly, it tells her nice job.
After Klackman finishes, the software gives a breakdown of her performance. The scorecard has a detailed graph showing the average number of compressions per minute, how deep she was pressing down, and whether she was leaving enough time for recoil, or for the chest to fully expand in between compressions.
This is nothing like a typical training session.
“For a basic life support course,” Klackman says, “We really have no way of objectively measuring how they’re doing. We can subjectively do it, but it is very subjective. Now we have a complete objective way of determining how well they’re doing on those skills.”
Klackman has had to perform CPR many times, she used to work in the ICU, and says these mannequins, which are gender neutral, are designed to give the same resistance as a human body, and feel much more like the real thing.
In addition to changing how health care providers are learning to perform CPR, the American Heart Association’s Resuscitation Quality Improvement program changes how often they practice. Several studies have shown the skills required to successfully perform CPR can degrade rapidly, as quickly as six months after training. So instead of training every two years for several hours, health care providers will train for a half-hour every ninety days.
Since the simulation unit is mobile, there will be no need to travel for a course or even leave the hospital.
It will also save Presbyterian Hospital money.
“We do know we’re going to get significant cost savings from this,” says Dr. Cole Edmonson, Chief Nursing Officer at Presbyterian Hospital in Dallas. And the goal of the hospital, he says, just like every health organization across the nation, “Is to be able to deliver better care better outcomes and better costs.”
Texas Health Resources, which already has fifteen Mobile Simulation Stations, is one of the early adopters of the improvement program. The AHA says it has received positive responses from pilot tests of the new training program, and plans to implement it with other hospitals over the next several months.
There’s also “Another One Bites The Dust,” by Queen. Klackman says in trainigns, “we don’t care to use that one!”