Does management of cardiac arrest scenarios differ between residents of different disciplines? A comparison with simulation.

BACKGROUND Training multidisciplinary teams using simulation allows for communication, development and maintenance of teamwork. In this study we compared the behavior of residents from emergency and anesthesiology departments on treatment of cardiac arrest. METHODS 42 anesthesiology and 29 emergency residents are included in the study. Two scenarios were designed for diagnosis and treatment of asystole and ventricular fibrillation. First scenario was a case with ventricular fibrillation (VF) and the second was an asystole case. ACLS protocols were used for assessment. Age, years of training, and years in practice were compared for each group. RESULTS Anesthesiology residents attempted to secure the airway immediately after checking the carotid pulse and began the cardiac compressions. After intubation, the vast majority (88%) of participants monitorized the patient. Only 11.9% of the residents started compressions and were reminded to monitorize the patient. Emergency residents immediately started CPR with compressions and ventilation by mask. 79.3% of them decided to intubate after a few compressions but 20.7% of them didn't attempt it. 50% of the residents monitorized the simulator whereas the other half was reminded to. There was no significant difference between the groups in terms of ventricular fibrillation and asystole management, but the age of the doctors was a decisive factor affecting the success in the VF simulation. CONCLUSIONS This study demonstrates the use of simulation to identify the deficiencies in basic knowledge and the skills of emergency and anesthesiology residents. It highlights the need to emphasize criteria that should be used in resuscitation.