PP10 Does the use of a post-rosc checklist improve paramedic adherence to local clinical guidance? a mannequin-based pilot randomised controlled study

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Aims a BackgroundThe primary aim of this pilot study was to identify whether the use of a checklist could improve paramedic adherence to a clinical guideline during the management of a simulated cardiac arrest patient with the return of spontaneous circulation (ROSC). Increasingly checklists have been shown to reduce mortality and morbidity across a variety of healthcare settings. However there is currently no literature looking at the potential benefits of checklists on UK out-of-hospital cardiac arrest (OOHCA) management.MethodThe study took a convenience sample of nine paramedics from one NHS ambulance service trust. Participants were randomised to one of two groups. Group A, the intervention group, was asked to utilise the checklist on attaining ROSC. Group B, the control group, were asked to manage the ROSC patient in line with standard clinical practice. The results from each participant were recorded on a marking grid, scored out of a possible twenty four points by two individual markers.ResultsFive participants were randomised to group A achieving a median score of twenty three. The other four clinicians were randomised to group B achieving a median score of fourteen. Results were analysed using SPSS software using the Mann-Whitney U test for non-parametric data, producing a p-value of 0.014. This statistical value demonstrates a statistically significant difference within the data.ConclusionThere is a statistically significant difference (p<0.05) between paramedics who utilise and those who do not utilise a checklist for the management of the post-ROSC patient, suggesting that those who do have a greater adherence to clinical guidance. However, the results from this small-scale pilot study cannot imply that the use of a checklist will improve the number of patients that survive to hospital discharge following an OOHCA. Further research is required to identify if there is a clinical significance in using checklists within UK paramedic practice.

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