Abstract
Introduction: A number of public access defibrillators incorporate computerised audio-visual feedback mechanisms to help responders deliver cardiopulmonary resuscitation (CPR) according to current guidelines. A 2013 American Heart Association statement suggested that chest compression fraction (CCF) and compression rate should be prioritised over compression depth, chest recoil and ventilations. This usability study assessed the effect of real-time rate-only feedback on chest compression depth. Methods: Randomly selected users were recruited in a shopping mall (n=141; 15-65+ years) to deliver CPR using a public access defibrillator in a simulated scenario. Participants were randomly assigned one of two devices - (1) with CPR rate feedback in the form of a machine-interface comprising of audio-voice prompts and light emitting diodes; (2) without CPR feedback. Participants were instructed to turn on the device and follow the prompts, with no information on how to perform CPR provided. CPR rate and depth were captured by measuring displacement of a potentiometer contained in a specially designed manikin. The device was connected to the manikin via the electrode leads. The effect of rate-only feedback on compression depth and CPR fraction were assessed. Results: ANCOVA analysis between the two devices provided a mean difference (Standard Error; SE) of 4.52mm (1.38mm) indicating a statistically significant difference (p-value=0.001) between measured CPR depth favouring the device with CPR rate feedback. There was no significant difference in CCF between the devices. ANCOVA analysis provided a mean difference (SE) of 2.9% (1.9%) for the device with CPR rate feedback compared to the device without CPR rate feedback. Conclusion: The incorporation of clear, intuitive, audio-visual machine-interface that delivers CPR feedback can assist trained and untrained users in the optimisation of chest compression rate and maintain a high CCF. In conclusion, CPR rate-only feedback was not detrimental to chest compression depth and suggests rate-only feedback may improve compression depth.
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