Abstract
BackgroundResuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest. Whether effective continuous feedback could also be given verbally by a second rescuer (“human feedback”) has not been investigated yet. We, therefore, compared the effect of human feedback to a CPR feedback device.MethodsIn an open, prospective, randomised, controlled trial, we compared CPR performance of three groups of medical students in a two-rescuer scenario. Group “sCPR” was taught standard BLS without continuous feedback, serving as control. Group “mfCPR” was taught BLS with mechanical audio-visual feedback (HeartStart MRx with Q-CPR-Technology™). Group “hfCPR” was taught standard BLS with human feedback. Afterwards, 326 medical students performed two-rescuer BLS on a manikin for 8 min. CPR quality parameters, such as “effective compression ratio” (ECR: compressions with correct hand position, depth and complete decompression multiplied by flow-time fraction), and other compression, ventilation and time-related parameters were assessed for all groups.ResultsECR was comparable between the hfCPR and the mfCPR group (0.33 vs. 0.35, p = 0.435). The hfCPR group needed less time until starting chest compressions (2 vs. 8 s, p < 0.001) and showed fewer incorrect decompressions (26 vs. 33 %, p = 0.044). On the other hand, absolute hands-off time was higher in the hfCPR group (67 vs. 60 s, p = 0.021).ConclusionsThe quality of CPR with human feedback or by using a mechanical audio-visual feedback device was similar. Further studies should investigate whether extended human feedback training could further increase CPR quality at comparable costs for training.
Highlights
Resuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest
The aim of our study was to investigate in a tworescuer scenario whether feedback from trained humans could be as effective for CPR quality as from a mechanical audio-visual feedback device
Upon inclusion in the study, all students had received 2 h of basic Basic life support (BLS) training on a manikin following a standardised teaching protocol of the Medical University of Vienna according to the International Liaison Committee on Resuscitation (ILCOR) guidelines for adult automated external defibrillator BLS (AED-BLS) [8]
Summary
Resuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest. Experts agree that without understanding CPR performance, an improvement of performance, which could prevent many deaths due to cardiac arrest, cannot occur [4]. To address this issue, the 2010 International Liaison Committee on Resuscitation (ILCOR) guidelines highlighted the importance of optimising the resuscitation process and CPR parameters while endorsing the use of feedback devices in clinical practice as part of a comprehensive system of care for cardiac arrest [8]. A systematic meta-analysis of feedback devices in human and manikin studies simulating CPR scenarios showed chest compression parameters closer to recommendations, there is no evidence that this would translate into better patient outcomes [12]
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