Abstract 12065: CPR Prompting Devices: Unintended Consequences Impacting High Performers

Abstract

Introduction: Prompting devices for chest compressions have been advocated as a means of improving CPR quality in previous AHA guidelines. Studies have shown overall CPR quality improves with the use of these devices. Hypothesis: This study compared the impact of prompting devices on providers with varying levels of experience and proficiency. Methods: A convenience sample of 53 subjects with varying degrees of CPR experience, ranging from zero to frequent opportunities to perform CPR, were enrolled. Using a skills recording CPR manikin, data on each subject’s chest compression performance was obtained. All subjects performed an initial one-minute cycle of continuous chest compressions with no prompting device. After a brief rest, subjects were randomized to use one of two CPR prompting devices (Philips MRX with Q-CPR or Laerdal Medical CPRmeter). An additional one minute of CPR was conducted with the first device. Subjects were then crossed over to use the other prompting device after another brief rest. Results: Across the entire group, nearly all parameters significantly improved with the prompting devices, confirming previous studies on the efficacy of CPR prompting devices. However, when subjects’ results were examined by breaking the group into three performance levels (high, medium and low) based on the Overall CPR Score generated by the manikin software, there were differences in performance. Paired t -tests were conducted on the low and high performance groups. The low-level group significantly improved across 7 of 8 variables with both devices. The high-level group had only minor changes from baseline (both positive and negative) in most variables, but had significant or near significant decrease in proficiency in one variable - percent correctly released compressions ( p = 0.011 for Philips device; p = 0.052 for the Laerdal device). Conclusions: CPR prompting devices improve the overall quality of chest compressions. Individuals with existing high performance CPR skills could be distracted by the device, reducing the quality of compressions compared to using no device. When a CPR prompting device is introduced into a health care system, all providers, especially high performers, require practice with the device in order to acclimate to its use.