The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

EVALUATION OF HEALTH CARE PRACTITIONERS ASSESSING BREATHING PATTERNS

Yoshihiro Uzawa1, Norihiro Kaneko2, Ryuji Hara1



Background: Basic Life Support (BLS) is a fundamental skill for health care practitioners (HCPs). Guidelines for American Heart Association (AHA) training programs include teaching assessment-based algorithms and psychomotor skills of CPR by using an inanimate mannequin. However, during BLS training, it is impossible for participants to experience real breathing assessments using the static mannequin. In the clinical setting, patients who require medical intervention may be apneic, bradypneic, tachypneic or have agonal breathing. This study was designed to assess whether HCPs who completed a traditional BLS program could recognize various breathing patterns and follow proper procedure applicable to that breathing pattern when they encountered a dynamic mannequin.

Methods and Material: Subjects were 48 HCPs (physical therapists 33, occupational therapists 9, and speech pathologist 6) who had previously completed an AHA BLS program for HCPs. Four breathing patterns were presented in a randomized order using a human patient simulator (HPS METI, Medical Education Technologies, Inc. Sarasota, FL): apnea, bradypnea (5 bpm), normal (15 bpm), and tachypnea (35 bpm). Subjects were asked to identify the breathing patterns as either normal, abnormal or apnea, and were also asked if bag-valve-mask ventilation (BVM) was required. Correctness of identification of breathing pattern and the time taken for identification were observed. The level of confidence for the subjects' identification of breathing pattern and the use of BVM was measured using a 100 mm visual analog scale. The time to identification and level of confidence were compared statistically using analysis of variance (ANOVA).

Results: The average time to decision was 14.5 +/- 6.6 seconds. Tachypnea tended to be identified sooner and bradypnea was prone to a delay (p<0.05). In the level of confidence, there was no significant difference in identification of breathing patterns; however, there was a significant difference as to whether BVM was indicated between breathing patterns (p<0.01).

Discussion: Subjects performed similarly identifying apnea and normal breathing patterns; however, a delay in response and less confidence were observed when the subjects encountered bradypnea and tachypnea breathing patterns.

Conclusion: Based on these results, identification and evaluation of breathing patterns and CPR technique should be included for HCPs during BLS courses.