For better cardiac outcomes, they want their MTV

Let's go to the videotape: North Shore University Hospital emergency medicos practice their life-saving CPR techniques.
By GREGORY ZELLER //

For those who suffer cardiac arrest outside of a hospital setting, the odds are not good – less than 8 percent survive, according to the Feinstein Institutes for Medical Research.

To improve their odds once they reach the hospital, researchers at Manhasset’s North Shore University Hospital and the Feinstein Institutes have taken a decidedly backwards step – if not in terms of medical science, certainly in terms of video technology.

With the smarter administration of life-saving cardiopulmonary resuscitation and, ultimately, improved survival rates in mind, the team has developed a novel approach called Mechanical, Team-Focused, Video-Reviewed Cardiopulmonary Resuscitation – essentially, using simple videotaped recordings of CPR training sessions (and live cases) to improve performances.

It seems fairly unsophisticated – videotaping practices and performances, reviewing the tapes and making appropriate changes. The kind of thing a baseball player or a high school drama coach might do.

But according to the results of a first-of-its-kind study of the MTV-CPR approach, published Tuesday in the Journal of the American Heart Association, the tape-and-review process has had profound effects.

Tape measure: Becker (left) and Ralston, all heart.

Lance Becker, a professor in Feinstein’s Institute of Bioelectronic Medicine who spearheaded the research with NSUH emergency medicine specialist Daniel Rolston, called it a “simple yet powerful idea,” noting that the videotaping of staff CPR sessions provided a wealth of useful data.

“Our data support the benefit of actively reviewing and improving on real-world CPR techniques to save peoples’ lives,” noted Becker, who also chairs the Emergency Department at Long Island Jewish Medical Center. “When we saw a problem, we developed new protocols to overcome each challenge.”

The study, conducted in 2018 and 2019, equipped four NSUH Emergency Department “resuscitation rooms” with cameras and video-review technology and monitored 151 total cardiac-arrest “cases,” featuring both practice dummies and actual cardiac patients. Becker, Rolston et al reviewed each tape to find even the smallest possible mistakes, create new techniques and otherwise identify possible improvements.

By reducing chest-compression interruptions, developing new and more specific roles for each eight-person response team and creating new “coordinated transition methods” between manual and mechanical resuscitation, MTV-CPR led to dramatically better outcomes – the percentage of patients achieving ROSC (the “return of spontaneous circulation”) increased from 26 percent to 41 percent, according to the study.

This was not the first time Becker and friends have taken profound steps toward better care for cardiac patients, noted Feinstein Institutes President and CEO Kevin Tracey.

“Dr. Becker and his team have led early, national efforts to put defibrillators in public spaces,” Tracey said in a statement. “Now they are leading this new effort to prevent sudden cardiac deaths in hospital emergency departments.”