A deeper insight in Advanced Cardiac Life Support

In Belgium, every day approximately 30 adults will suffer from an unexpected out-of-hospital cardiac arrest (OHCA). Therefore, patients must have confidence in health care professional and put their lives in their hands. To earn that trust, physicians should at least act according to the expected standards, especially in an era where patient safety is an absolute priority. The use of medical skills laboratories (MSL) in education has already proven their benefit in teaching and practicing technical skills. A MSL provide a safe and protected environment where the student can practice clinical skills – such as resuscitation – before using them in real clinical situations. However, the principle of ‘see one, do one, teach one’ is old-fashioned and needs an urgent update. Therefore, at present, medical skills laboratories are not limited to teach the necessary technical skills.  They also provide a proper assessment before the student is allowed to work with real patients. Furthermore, new learning strategies and technologies are being introduced to ensure that medical personnel are well-prepared to face ever-increasing challenges in- or out-of-hospital. However, at present it’s unclear whether the implementation of a MSL also improves the compliance with Advanced Cardiac Life Support (ACLS) guidelines.  Subsequently, and probably even more important, it’s also unclear whether a MLS would improve outcome. Therefore, the aim of this new research is to assess the optimal design and effectiveness of resuscitation training. This will allow us to determine whether an excellent virtual reality resuscitation performance will provide an equally outstanding performance in daily life.

Finally, only in the event of an excellent implementation of the ACLS guidelines and an optimal resuscitation performance, we can consider the integration of alternative resuscitation methods to conventional manual CPR in order to further improve outcome. Typically, these techniques and devices require more personnel, training and equipment. One of these techniques is the use of Extra Corporeal Membrane Oxygenation (ECMO), which involves a quite challenging medical decision. There is not only the potential delay or interruption of CPR,  but it is also known that it is effective only in selected settings and patient conditions.

In conclusion, the ‘chain of survival’ can only survive if we take out all the weak links. This project will provide us novel insight into how to optimally organize medical simulation in order to improve patient outcome. Furthermore, the integration of ECMO will be investigated as an addition to the chain of survival. Only than we can conclude that medical simulation will indeed be the future of our healthcare education and training.