Monitoring Cardiopulmonary Resuscitation Quality in Emergency Department: A National Survey in China on Current Knowledge, Attitudes, and Practices

Background: To investigate current knowledge, attitudes, and practices for CPR quality control among emergency physicians in Chinese tertiary hospitals.Methods: Anonymous questionnaires were distributed to physicians in 75 tertiary hospitals in China between January and July 2018.Results: A total of 1405 respondents answered survey without obvious logical errors. Only 54.4% knew all criteria of high-quality CPR. The main problems during CPR were related to chest compression: low quality due to fatigue (67.3%), inappropriate depth (57.3%) and rate (54.1%). 91.0% respondents considered CPR quality monitoring should be used, 72.4% knew objective method for monitoring, and 63.2% always/often monitored CPR quality during actual resuscitation. The utilization rate of recommended monitoring methods was reported as follow, ETCO2 was 42.7%, audio-visual feedback devices was10.1%, coronary perfusion pressure was 17.9%, and invasive arterial pressure was 31.1%. 96.3% respondents considered it was necessary to participate in regular CPR retraining, but 21.4% did not receive any retraining. The ideal retraining interval was considered to be 3 to 6 months, but actual interval was 6 to 12 months. CPR feedback devices were always/often used in training was reported by 49.7% of respondents.Conclusion: Chinese emergency physicians were very concerned about CPR quality, but they did not fully understand the high-quality criteria and impact on prognosis. CPR quality monitoring was not routine procedure during actual resuscitation. The methods recommended in guidelines were rarely used in practice. Many physicians have not received retraining or have received retraining at long intervals. Feedback devices were not commonly used in training.