Abstract: TH-PO309
Cardiac Arrest in Dialysis Units: A National Cross-Sectional Survey Evaluating the Experience of Dialysis Technicians
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Catanese, Benjamin Peter, Duke University Health System, Durham, North Carolina, United States
- Fish, Laura Jane, Duke University, Durham, North Carolina, United States
- Rim, Jeeyon Grace, Duke University Health System, Durham, North Carolina, United States
- Blewer, Audrey L., Duke University School of Medicine, Durham, North Carolina, United States
- Falkovic, Margaret, Duke University, Durham, North Carolina, United States
- Pun, Patrick H., Duke University Health System, Durham, North Carolina, United States
Background
Cardiac arrest is the number one cause of death for hemodialysis patients, and often occurs in outpatient dialysis clinics. Immediate cardiopulmonary resuscitation (CPR) decreases mortality, but CPR is not performed during some cardiac arrests in dialysis clinics. Dialysis technicians are the most common first line providers within US outpatient dialysis clinics, but little is known about their training, experience, and preparedness to provide CPR. We conducted a nationwide survey to understand barriers to CPR among dialysis technicians.
Methods
We conducted a cross-sectional survey of National Association of Nephrology Technicians/Technologists members. The survey was distributed via email and at a national conference. Questions included details about current dialysis unit, demographics, basic life support (BLS) training, experience with cardiac arrests, confidence in performing the steps of BLS, and rating of potential barriers to CPR in the dialysis clinic. Data were analyzed using descriptive statistics.
Results
101 technicians completed the survey, with a median work experience of 10 years. 75% reported BLS training within the past year, 88% had knowledge of a unit-specific CPR protocol and 74% had participated in mock codes. 80% witnessed a dialysis clinic cardiac arrest (median 4 cardiac arrests witnessed). For patients who had an in chair intradialytic cardiac arrest, technicians reported that CPR was performed 53% of the time in the dialysis chair and 47% on the floor (moved from the chair). Respondents reported high levels of confidence for performing each step of BLS (65%±7% selecting the highest level on a 5-point Likert scale), but only 33% reported the same level of confidence that their dialysis team could resuscitate a patient that arrested. The most significant barriers to performing CPR in the dialysis clinic were delay in recognizing the patient had a cardiac arrest (44%) and fear of harming the patient (41%).
Conclusion
Despite a high proportion citing completion of best practice CPR training, 2/3 of dialysis technicians did not feel highly confident that their teams could resuscitate patients. Novel barriers to CPR include delay in cardiac arrest recognition, lack of agreement in positioning of patients for CPR, and fear of harming patients during CPR.
Funding
- Clinical Revenue Support