Comparison Between Advanced Cardiovascular Life Support Course and a New Emergency Cardiovascular Care Course for Developing Countries

Introduction: Training and cardiovascular emergency care (CEC) is different in developing countries from developed countries. Emergency medicine specialty in developing countries is not established without a large number of specialists and the Advanced Cardiovascular Life Support course (ACLS) is a very common course. Objective: To compare the ACLS with the Advanced Cardiovascular Emergency Training course (TECA) developed in Brazil according to the needs of local doctors. Both courses with 16 hours of training but the TECA adding more skills training time in Arrhythmia, Stroke, Acute Coronary Care (ACC) and Acute Heart Failure (AHF) in addition to the traditional training in cardiac arrest management (CAM). Methods: The study included the participation of 119 senior medical students divided into 2 groups: 56 students submitted to TECA training and 63 students submitted to the ACLS course. Both groups performed a mannequin simulated CAM skills evaluation care before and after participating in each course and a multiple-choice test after training. Performance in simulated scenario was compared through structured assessment score, time to onset of chest compression and time to perform defibrillation after collapse, as well as the number of correct answers in the multiple-choice assessment. Results: TECA group presented statistical higher grade than the ACLS group in the evaluation of the simulated case attendance (10,0 points (9,00-10,00) vs 9,0 (8,00-10,00) points; p<0,001). There was no statistical difference between the groups in time to onset of chest compression (19,0 sec (16,25-23,00) vs 19,5 (15,75-25,25) sec; p = 0,500) and time to defibrillation (48,0 (39,00-53,00) sec vs 48,0 (39,00-55,00) sec; p = 0,740). TECA students had a better performance in questions related to AHF treatment (4,0 (3,00-4,00) vs 3,0 (2,00-3,00); p < 0,001). There was no significant difference in the number of correct answers on arrhythmia, CAM, ACC and stroke. Conclusions: TECA course provided greater adherence to CAM care protocol, without prejudice to the time to start chest compression or time to defibrillation. In addition, it added training in AHF management, suggesting to be a good option for cardiac emergency care training in developing countries.