A novel approach to life support training using "action-linked phrases"

Elizabeth A. Hunt, Hillenn Cruz-Eng, Jamie Haggerty Bradshaw, Melanie Hodge, Tammi Bortner, Christie L. Mulvey, Kristen N. McMillan, Hannah Galvan, Jordan M. Duval-Arnould, Kareen Jones, Nicole A. Shilkofski, David L. Rodgers, Elizabeth H. Sinz

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy. Methods: We hypothesized that when individuals utilized specific, short, easy-to-state action phrases stating an observation followed by an associated intervention, there would be a higher likelihood that appropriate action would immediately occur. Phase I: A retrospective analysis of residents in simulated CPAs measured what proportion verbalized "There's no pulse", statements and/or actions that followed and whether "Action-Linked Phrases" were associated with faster initiation of compressions. Phase II: Two prospective, quasi-experimental studies evaluated if teaching three Action-Linked Phrases for Basic Life Support (BLS) courses or six Action-Linked Phrases for Advanced Cardiovascular Life Support (ACLS) courses was associated with increased use of these phrases. Results: Phase I: 62% (42/68) of residents verbalized "there's no pulse" during initial assessment of a pulseless patient, and only 16/42 (38%) followed that by stating "start compressions". Residents verbalizing this Action-Linked Phrase started compressions sooner than others: (30. s [IQR:19-42] vs. 150 [IQR:51-242], p<. 0.001). Phase II: In BLS courses, the three Action-Linked Phrases were used more frequently in the intervention group: (226/270 [84%] vs. 14/195 [7%]; p<. 0.001). In ACLS courses, the six Action-Linked Phrases were uttered more often in the intervention group: (43% [157/368] vs. 23% [46/201], p<. 0.001). Conclusions: Action-Linked Phrases innately used by residents in simulated CPAs were associated with faster initiation of compressions. Action-Linked Phrases were verbalized more frequently if taught as part of a regular BLS or ACLS course. This simple, easy to teach, and easy to implement technique holds promise for impacting cardiac arrest teams' performance of key actions.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
StatePublished - Jan 1 2015

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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