Can J Emerg Med
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High-quality cardiopulmonary resuscitation (CPR) is a fundamental intervention for cardiac arrest, yet health care providers rarely adhere to recommended guidelines. Real-time feedback improves CPR performance. It is currently unknown how Canadian emergency physicians assess CPR quality during cardiac arrest and if they use feedback devices. Our aim was to describe how emergency physicians assess CPR quality and to describe eventual barriers to implementation of feedback technology. ⋯ Most Canadian emergency physicians that responded to our survey, assess quality of CPR by standing at the foot of the bed and utilize visual observation and palpation methods which are known to be inaccurate. A minority utilize objective measurements such as ETCO2 or feedback devices, with the greatest barrier being lack of availability.
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We designed two practical, user-friendly, low-cost, aesthetically pleasing resources, with the goal of introducing residents and observers to a new Competence by Design assessment system based on entrustable professional activities. They included a set of rotation- and stage-specific entrustable professional activities reference cards for bedside use by residents and observers and a curriculum board to organize the entrustable professional activities reference cards by stages of training based on our program's curriculum map. A survey of 14 emergency medicine residents evaluated the utilization and helpfulness of these resources. They had a positive impact on our program's transition to Competence by Design and could be successfully incorporated into other residency programs to support the introduction of entrustable professional activities-based Competence by Design assessment systems.
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Point-of-care ultrasound (POCUS) is used increasingly during resuscitation. The aim of this study was to assess whether combining POCUS and electrocardiogram (ECG) rhythm findings better predicts outcomes during cardiopulmonary resuscitation in the emergency department (ED). ⋯ The absence of cardiac activity on POCUS, or on both ECG and POCUS together, better predicts negative outcomes in cardiac arrest than ECG alone. No test reliably predicted survival.