The Science Journal of the American Association for Respiratory Care
Purpose: Health care professionals must be able to recognize lethal arrhythmias at the bedside and know the immediate action that will increase the likelihood of a positive outcome. The purpose of this study was to assess the ability of graduating baccalaureate degree respiratory care and nursing students to identify and recommend appropriate treatment of lethal arrhythmias as displayed on an arrhythmia simulator. Method: Respiratory care (RT) and nursing (RN) students enrolled at a university health science center and nearing the end of their respective programs were shown five cardiac rhythms, including normal sinus rhythm, ventricular tachycardia, ventricular fibrillation, asystole, and third degree heart block. Each was asked to identify the rhythms and recommend appropriate action. Arrhythmias were generated by an Armstrong Medical Industries, Inc. AA-820 patient simulator and were displayed on a Biomedical Systems 401 patient monitor. The ability of respiratory care and nursing students to recognize and appropriately treat lethal arrhythmias was assessed with a quiz composed of 10 questions, worth 10 points each, and scores were expressed as a percentage. Scores were reported for rhythm recognition, appropriateness of action to treat the arrhythmia, and total correct responses. Mean scores were compared using an independent t-test with p < 0.05 being considered significant.
Results: Demographic data and mean scores (SD) are shown in Table 1. Graduating RT's recognized significantly more lethal arrhythmias than graduating RN's, and chose the appropriate corrective action significantly more often than RN students. As expected from these results, total points scored by RT students were significantly higher than those scored by RN students.
Conclusions: Respiratory therapists and nurses treat patients who are at risk for development of lethal arrhythmias. The results of this study suggest that respiratory therapy students are better prepared to identify and recommend appropriate treatment of common arrhythmias encountered in the clinical setting, when compared with nursing students. The results are not surprising since respiratory therapy students undergo rigorous instruction in cardiac and pulmonary pathophysiology. In today's changing health care environment, clinicians who possess excellent bedside assessment skills and the knowledge to act quickly and appropriately in the face of a crisis are valuable members of the health care team and will contribute to improved patient outcomes.
Table 1. Scores for lethal arrhythmia recognition and knowledge of appropriate action to be taken for graduating nursing and respiratory care students.
|ID score, %||92.5(10.0)||80(18.1)||2.44||0.02*|
|TX score, %||61.3(13.6)||43.3(15.7)||3.53||0.001**|
|Total score, %||76.9(10.1)||61.7(14.7)||3.47||0.002**|
|* p < 0.05||ID score - score for arrhythmia recognition|
|** p < 0.01||TX score - score for appropriate action recommended|