Real-Time Cardiopulmonary Resuscitation Feedback and Targeted Training Improve Chest Compression Performance in a Cohort of International Healthcare Providers.

Abstract

Optimal cardiopulmonary resuscitation (CPR) performance is the foundation of successful cardiac arrest resuscitation. However, health care providers perform inadequate compressions. Better training techniques and real-time CPR feedback may improve compression performance. We sought to evaluate the impact of a targeted training program combined with real-time defibrillator CPR feedback on chest compression performance in an international cohort of health care providers. Physicians, nurses, respiratory therapists, and technicians from 6 hospitals in 5 countries (Taiwan, Singapore, China, Bahrain, and Kuwait) participated in a standardized resuscitation workshop. Chest compression was measured before and after didactics and activation of CPR feedback. Compressions were performed for 1min on standard CPR manikins placed on a hospital bed and backboard and measured using ZOLL R Series defibrillators. The percentage of compressions meeting target values for depth and rate were compared before and after the workshop and activation of real-time CPR feedback. No depth maximum was defined to allow for mattress compression. Chest compressions were more likely to meet targets for depth (71-95%, odds ratio [OR] 8.61 [95% confidence interval {CI} 4.42-16.77], p<0.001), rate (41-81%, OR 6.4 [95% CI 4.2-9.8], p<0.001), and both depth and rate (5-42%, OR 2.4 [95% CI 6.7-22.9], p<0.001) after the workshop and activation of real-time CPR feedback. A targeted training intervention combined with real-time CPR feedback improved chest compression performance among health care providers from various countries.