Third Annual EMS R ESEARCH S UMMIT Third Annual EMS R ESEARCH S UMMIT

All monitors used locally can collect data during the performance of CPR All monitors used locally can collect data during the performance of CPR Hands-on time Hands-on time Compression rates and ratio Compression rates and ratio Compression depth and other compression information Compression depth and other compression information CPR pauses (e.g., before and after defibrillation, etc.) CPR pauses (e.g., before and after defibrillation, etc.) Data from these files are useful for crews, agencies, and research. Data from these files are useful for crews, agencies, and research. All monitors used locally can collect data during the performance of CPR All monitors used locally can collect data during the performance of CPR Hands-on time Hands-on time Compression rates and ratio Compression rates and ratio Compression depth and other compression information Compression depth and other compression information CPR pauses (e.g., before and after defibrillation, etc.) CPR pauses (e.g., before and after defibrillation, etc.) Data from these files are useful for crews, agencies, and research. Data from these files are useful for crews, agencies, and research.

Philips Electronics Philips Electronics Three device manufacturers used in the region: Philips ZollMedtronic Zoll Medical Zoll Medical Medtronic Physio-Control Medtronic Physio-Control

Philips Q-CPR Compressions RhythmEvents Timeline Average Compression Rate (per min.) & Depth

Zoll RescueNet CPR ECG Chest Compression Depth Compression Rate

Physio-Control Code-Stat Compressions Rhythm Compressions Events & Assorted Vital Signs ROSC Statistics (1-minute intervals)

Individual case information Individual case information Research protocol implementation Research protocol implementation Time data Time data Aggregate information Aggregate information CPR quality across multiple cases CPR quality across multiple cases Identification of trends Identification of trends Information to enhance other available data Information to enhance other available data Initial rhythm Initial rhythm Outcome data Outcome data Medication timing and impact Medication timing and impact Individual case information Individual case information Research protocol implementation Research protocol implementation Time data Time data Aggregate information Aggregate information CPR quality across multiple cases CPR quality across multiple cases Identification of trends Identification of trends Information to enhance other available data Information to enhance other available data Initial rhythm Initial rhythm Outcome data Outcome data Medication timing and impact Medication timing and impact Monitor files generate data that can provide:

Large randomized clinical trials Large randomized clinical trials PRIMED PRIMED Observational studies Observational studies Chest Compression Fraction in VF/VT Chest Compression Fraction in VF/VT Quality of CPRnationwide feasibility study in Denmark Quality of CPRnationwide feasibility study in Denmark Randomized studies of feedback Randomized studies of feedback Real-time feedback studyROC Real-time feedback studyROC Feedback studyGermany Feedback studyGermany Several studies have recently used data from monitor files:

Multicenter observational study of 506 CPR files (largest of its kind to date) Multicenter observational study of 506 CPR files (largest of its kind to date) Investigated the association of chest compression fraction (CCF)* with survival in patients presenting in VF/VT Investigated the association of chest compression fraction (CCF)* with survival in patients presenting in VF/VT Evaluated CCF during the period prior to first shock Evaluated CCF during the period prior to first shock Conclusions: Conclusions: More time spent performing chest compressions in the early phase of resuscitation substantially affects survival More time spent performing chest compressions in the early phase of resuscitation substantially affects survival Some questions are unanswered, and further studies are necessary Some questions are unanswered, and further studies are necessary *Proportion of time spent delivering chest compressions. Chest Compression Fraction Determines Survival in Patients with Out-of-Hospital VF

Chart (incident report) writing Chart (incident report) writing Cardiac arrest management QI/QA Cardiac arrest management QI/QA CPR quality review CPR quality review Protocol compliance Protocol compliance Reasons/Context for pauses in CPR Reasons/Context for pauses in CPR Best practices for cardiac arrest treatment Best practices for cardiac arrest treatment Objective measures of time Objective measures of time Agency-specific performance Agency-specific performance Chart (incident report) writing Chart (incident report) writing Cardiac arrest management QI/QA Cardiac arrest management QI/QA CPR quality review CPR quality review Protocol compliance Protocol compliance Reasons/Context for pauses in CPR Reasons/Context for pauses in CPR Best practices for cardiac arrest treatment Best practices for cardiac arrest treatment Objective measures of time Objective measures of time Agency-specific performance Agency-specific performance Monitor files, when reviewed with the chart, can aid in:

Code-Stat Case Report QI Feedback to Field Providers Overall Performance Initial Rhythm Compressions & Other Events (analysis, shocks, ROSC, etc.)

Compression Depth (inches) Zoll CPR Summary Analysis Time On/Off Chest Compression Rate QI Feedback to Field Providers

Average Compression Depth Philips Q-CPR Report Card Average Compression Rate Compression Depth (% adequate) QI Feedback to Field Providers

Is useful for objective case review Is useful for objective case review Can enhance treatment Can enhance treatment Can help clarify the timing and effectiveness of protocol changes Can help clarify the timing and effectiveness of protocol changes Is critical to advancing the science of cardiac arrest care Is critical to advancing the science of cardiac arrest care Is useful for objective case review Is useful for objective case review Can enhance treatment Can enhance treatment Can help clarify the timing and effectiveness of protocol changes Can help clarify the timing and effectiveness of protocol changes Is critical to advancing the science of cardiac arrest care Is critical to advancing the science of cardiac arrest care Cardiac monitor file data: