ABSTRACTS
Prehospital Clinician Experiences with CPR-Induced Consciousness: Preliminary Results of an Ongoing International SurveyAuthor: Erin Donathan, MPH, FPC | | Associate Authors: Ginny Renkiewicz, PhD, MHS, Michael Hubble, PhD, MBA
Introduction CPR-induced consciousness (CPR-IC) is a relatively novel phenomenon that is increasing in incidence, possibly due to the introduction of compression-only bystander CPR, an increase in clinician-provided high-quality CPR, and compression-assist device implementation. CPR-IC is defined as consciousness or other signs of life during CPR despite a lack of return of spontaneous circulation. Although this event is rare, it can be traumatic for the provider and potentially disruptive to patient care. Objective To explore the phenomenon of CPR-IC in the clinical setting among a convenience sample of international prehospital clinicians. Methods A solicitation containing a link to a voluntary 36-item Qualtrics survey was emailed by the National Association of Emergency Medical Technicians to 5,512 international and 1,000 U.S. members. The Irish Prehospital Emergency Care Council emailed the survey to an additional 4,226 prehospital clinicians. The survey was translated into 18 languages using professional translators to ensure accuracy and legibility. Results EMS clinicians from 32 countries submitted 832 responses from May–June 2023; 825 respondents consented to participate. After removing incomplete records, 602 surveys were available for analysis, including 341 (56.64%) paramedics, 168 (1.30%) AEMTs, and 193 (32.06%) EMTs. The average age of respondents was 41 (±10.80) years, 481 (79.90%) were male, 119 (19.77%) were female, and 2 (0.33%) identified as “another/different” term. Respondents had an average of 14.87 (±9.82) years of EMS experience. Most (47.86%) worked in urban environments, followed by suburban (35.05%), and then rural (17.08%). Of the respondents, 51.16% reported having initial (15.78%) or continuing (35.38%) education on CPR-IC, and 52.99% reported witnessing CPR-IC at least once in their career. Most (57.94%) respondents reported that they did not have an established protocol for CPR-IC within their organization, and over a third (35.71%) believed that the occurrence of CPR-IC disrupted their patient care. Conclusions Among respondents to this international survey, over half (52.99%) reported witnessing CPR-IC at least once. However, a substantial proportion of the respondents indicated that they had not received education (48.84%) on the topic and lacked protocols (57.94%) specific to CPR-IC management. The addition of CPR-IC into EMS education and research is needed on the appropriate treatment of this anomaly.
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