Implementing a Cardiac Arrest Model and Code Simulation in Interventional Radiology: A New Standard for Emergency Preparedness

The purpose of this study was evaluating the impact of code simulation within Interventional Radiology and its impact on code preparedness.

Materials and Methods:

The IR code response model and evidence for early defibrillation and CPR were introduced through educational presentation to all clinical IR staff. An initial baseline assessment was performed using a 16-point survey ranked on five-point Likert scale. The survey measured understanding of ACLS and BLS algorithms, perception of experience in codes, code roles, simulation benefit, confidence in assessment skills and confidence in common code interventions. The survey was based on the code confidence survey created by Cappella et al. then used by Tufts et al and Tofil et al.  Following baseline assessment, monthly code simulations were implemented, with a goal of each staff member participating at least once per quarter. Simulations were conducted with high fidelity simulator mannequins along with volunteer ICU staff. Simulations lasted 15-20 minutes and ran clinical scenarios frequently seen in IR. Time to defibrillation and time to CPR were tracked from time of arrest. Post scenario, staff participated in a guided debrief to discuss the scenario. The same survey was conducted post procedure as well as quarterly. Data was analyzed using non-parametric Chi squared tests due to the categorical nature of the data.

Results:

Over a 10-month period ranging from December 2023 to September 2024, there were 21 pre-simulation survey respondents and 35 post-simulation survey respondents. The responses included a diverse team of nurses, radiology technicians, resident physicians, and advanced practice providers. A total of 5 code simulations were performed during the study period. There was a statistically significant improvement in staff agreement with the statements “I know the BLS algorithm” (P 0.0075), “I need more experience with codes” (P 0.019), “I know my role in a code” (P 0.003) when comparing pre and post simulation survey responses. There was statistically significant increase in agreement that participating in code simulations and team debriefing is beneficial (P < 0.0001).

Conclusion:

Development and implementation of code simulations within Interventional Radiology allows for increase in staff confidence and understanding of code preparedness, which would result in better training and improvement patient outcomes.