A race against time: Does Epinephrine compliance by emergency physicians increase ROSC in cardiac arrest patients
AffiliationThe University of Arizona College of Medicine - Phoenix
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PublisherThe University of Arizona.
DescriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
AbstractOne of the most crucial medicinal intervention during a cardiac arrest is epinephrine. Advanced cardiac life support (ACLS) guidelines lays out the recommendation of delivering epinephrine every 3 – 5 minutes. The purpose of this study is to evaluate if physicians are compliant with delivering epinephrine as recommended, and how does compliance vs. non-compliance affect patient outcomes as measured by attaining return of spontaneous circulation (ROSC). The design of this study is a retrospective chart review with analysis, using Wilcox-Rank sum and Chi-Square fisher exact test to evaluate for statistical significance, which was defined with a P value < 0.05. There were 111 patient charts included in the study, and the results were charted into 3 categories: demographics by non-compliance, any non-compliance and mean non-compliance, and demographics by sinus rhythm. None of the results showed any statistical significance except for the mean number of doses a patient receives to achieve sinus rhythm, which was a mean of 10.3 vs 3.95. Although this study did not achieve statistical significance overall, it highlighted some clinical significance that may be of importance moving forward for all physicians. One clinical aspect that this study highlights further is the health disparity that people of color encounter. Patients who are people of color experienced higher mean number of noncompliance and percentage of any non-compliance. The overall conclusion that this study emphasized is that more studies into the overall quantity of epinephrine given during resuscitation may be worthwhile. Additionally, further emphasis on the importance of physician awareness of health disparity among people of color is needed.