Nurses prepare epinephrine faster than physicians in simulated cardiac arrest

Introduction: One million people die of cardiac arrest every year in the United States and Europe, almost one person every 30 sec. These patients can be managed with cardiopulmonary resuscitation. Objective: Rapid preparation and administration of drugs may be of importance in the management of cardiac arrest. The present study evaluated the time needed by physicians and nurses to prepare a vial of epinephrine (1mg) for intravenous administration. Methods: This prospective observational, simulation study was conducted at a large tertiary hospital in Athens. Ninety three healthcare professionals participated voluntarily. All participants were asked to assemble a 10cc syringe, draw up 1cc of 1:1.000 concentration of epinephrine and draw up 9cc of sterile water into the 10cc syringe. We arbitrarily set a period of 10sec as an acceptable time to prepare epinephrine for intravenous administration. A descriptive, quantitative design was selected. Results: Twenty nine percent of the participants performed the task within the 10 sec period. Nurses (45.6%) performed the task in less than 10 sec in comparison to physicians (2.8%), (p<0.001). Doctors had approximately 30 times higher probability to overcome the cutoff point of 10 sec (Odds ratio: 29.4; 95% Confidence interval: 5.3-162.2) than nurses. No statistically significant difference was observed between healthcare professionals that had attended a CPR course and those who did not (21.37±12.6 sec vs 19.21±16.31 sec, p=0.68). Conclusion: Nurses prepare and administer epinephrine faster than physicians. Hospital doctors should receive practical education in the early stages of their working life. Furthermore, demonstration of the skill during advanced life support courses should be considered.