Abstract

Background: Public access defibrillation (PAD) with automated external defibrillator (AED) is a widely available and beneficial intervention for cardiac arrest. The quality of chest compressions (CC) is an important determinant of the outcome of cardiopulmonary resuscitation (CPR). In Japan, AED with real-time audiovisual feedback is being implemented, and has been available to bystanders since 2011. However, the benefit of CC feedback systems for laypersons remains unclear. In this study, we sought to determine the effects of audiovisual feedback system on the quality of CC in bystanders with different medical backgrounds. Methods: A total of 478 individuals (151 healthcare professionals [mean age, 31.3 years], 76 medical students [mean age, 23.6 years], and 251 non-healthcare professionals [mean age, 40.1 years]) participated in a CPR quality improvement challenge. Participants performed two 2-min trials of CC on a training manikin equipped with an accelerometer-based system for measuring both rate and depth of CC. Real-time audiovisual feedback was disabled during first trial, but activated during the second trial. The quality of CC was evaluated by counting the number of compressions with the appropriate depth (5.0-10 cm) and rate (100-120 cpm) in each trial. Results: Among all participants, mean depth of CC was higher (6.35 vs. 5.87 cm), and mean rate was lower (102.4 vs. 112.2 cpm) when the feedback system was activated than when it was disabled (p < 0.05). When real-time feedback was activated, non-healthcare professional participants performed CC of greater depth (6.41 vs. 5.63 cm) than healthcare professionals (6.25 vs. 6.09 cm) and medical students (6.34 vs. 6.19 cm) (p < 0.05). The quality index of CC, which the percentage of adequate depth and rate, was also significantly improved regardless medical backgrounds (p < 0.05). Conclusions: The use of real-time CPR feedback systems improves the quality of CC performed by individuals of all backgrounds, especially non-healthcare personnel. PAD with AED providing CPR feedback technologies may elevate the survival rate of out-of-hospital cardiac arrest and increase the likelihood of favorable outcomes.

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