Cardiopulmonary Resuscitation Feedback Devices Research Articles

Improving Cardiopulmonary Resuscitation Quality and Resuscitation Training by Using Real-Time Audiovisual-Assisted Devices.

Context Cardiac arrest occurring outside of a medical facility is a significant cause of death and disability worldwide. In developing nations, it accounts for a notable portion of total mortality, with only a small percentage of those affected surviving beyond the initial emergency department intervention. Despite the critical importance of high-quality cardiopulmonary resuscitation (CPR) in these situations, there has been limited research on the effectiveness of audiovisual feedback devices in improving CPR performance among laypersons or non-medical caregivers. These caregivers, often untrained in advanced medical procedures, play a crucial role in the immediate response to cardiac arrest before professional help arrives. This study aims to address this gap by evaluating the impact of such devices on CPR quality delivered by non-medical individuals. Aim This study aimed to determine whether the use of audiovisual devices would improve cardiopulmonary resuscitation performance among non-medical care providers. Materials and methods Using amultiple-choice questionnaire, an audiovisual aid-based prospective observational study (non-interventional observation study) was conducted at a medical college hospital in Kochi from June 2022 to February 2024. A minimum sample size of 66 was derived from pilot studies, with 95% confidence and 90% power. A total of 146 participants met the inclusion criteria (non-medical personnelof 18-50 years of age). After the exclusion ofpregnant women and non-interested participants, the study participants were analyzed for the quality of cardiopulmonary resuscitation in a mannequin with the help of audiovisual devices.Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 20 (IBM Corp., Armonk, New York, released in 2011). Categorical variables were expressed as frequency and percentage. McNemar's Chi-square test wasapplied to compare the CPR compression rates with and without the visual feedback device, and the kappa statistic was used to assesshow consistently participants performed within the same compression rate category (less than 100, 100-120, or more than 120 compressions per minute) with and without the feedback device. Results The improvement inCPR quality, which was visualized as a green color in the CPR feedback device, was significant, with 109 participants (74.7%) showing good outcomes. The chest compression rate also significantly improved from 95 to 117 with the use of feedback devices (p -0.011, Kappa - 0.167) among non-medical care providers. While the kappa value suggests that some variability exists in compression rates when switching between with and without feedback, the overall improvement is still noteworthy. Conclusion The majority of participants (74.7%) were able to consistently maintaingreen light in the visual feedback watch, which means their chest compression rate was within optimal range (100-120/min) when using the audiovisual feedback device. This indicated that use of audiovisual devicessignificantly improved compression rates among non-medical care providers andeffectively helped them perform high-quality CPR.

A smartwatch-based CPR feedback device improves chest compression quality among health care professionals and lay rescuers

Cardiopulmonary resuscitation (CPR) quality significantly impacts patient outcomes during cardiac arrests. With advancements in health care technology, smartwatch-based CPR feedback devices have emerged as potential tools to enhance CPR delivery. This study evaluated a novel smartwatch-based CPR feedback device in enhancing chest compression quality among health care professionals and lay rescuers. A single-center, open-label, randomized crossover study was conducted with 30 subjects categorized into 3 groups based on rescuer category. The Relay Response BLS smartwatch application was compared to a defibrillator-based feedback device (Zoll OneStep CPR Pads). Following an introduction to the technology, subjects performed chest compressions in 3 modules: baseline unaided, aided by the smartwatch-based feedback device, and aided by the defibrillator-based feedback device. Outcome measures included effectiveness, learnability, and usability. Across all groups, the smartwatch-based device significantly improved mean compression depth effectiveness (68.4% vs 29.7%; P < .05) and mean rate effectiveness (87.5% vs 30.1%; P< .05), compared to unaided compressions. Compression variability was significantly reduced with the smartwatch-based device (coefficient of variation: 14.9% vs 26.6%), indicating more consistent performance. Fifteen of 20 professional rescuers reached effective compressions using the smartwatch-based device in an average 2.6 seconds. A usability questionnaire revealed strong preference for the smartwatch-based device over the defibrillator-based device. The smartwatch-based device enhances the quality of CPR delivery by keeping compressions within recommended ranges and reducing performance variability. Its user-friendliness and rapid learnability suggest potential for widespread adoption in both professional and lay rescuer scenarios, contributing positively to CPR training and real-life emergency responses.

Temporal analysis of continuous chest compression rate and depth performed by firefighters during out of hospital cardiac arrest

BackgroundQuality of chest compressions (CC) during cardiopulmonary resuscitation (CPR) often do not meet guideline recommendations for rate and depth. This may be due to the fatiguing nature of physically compressing a patient’s chest, meaning that CPR quality reduces over time. ObjectiveThis analysis investigates the effect of CPR duration on the performance of continuous CCs delivered by firefighters equipped with CPR feedback devices. MethodsData were collected from a first responder group which used CPR feedback and automatic external defibrillator devices when attending out-of-hospital cardiac arrest events. Depth and rate of CC were analysed for 134 patients. Mean CC depth and rate were calculated every 5 s during two-minute episodes of CPR. Regression models were created to evaluate the relationship between applied CC depth and rate as a function of time. ResultsMean (SD) CC depth during the investigation was 48 (9) mm. An inverse relationship was observed between CC depth and CPR duration, where CC depth decreased by 3.39 mm, over two-minutes of CPR (p < 0.001). Mean (SD) CC rate was 112.06 (5.87) compressions per minute. No significant relationship was observed between CC rate and CPR duration (p = 0.077). Mean depth was within guideline range for 33.58% of patient events, while guideline rate was observed in 92.54% of cases. ConclusionsA reduction in CC depth was observed during two-minutes of continuous CCs while CC rate was not affected. One third of patients received a mean CC depth within guideline range (50 to 60 mm).

Comparison of the CPR Feedback Device Effect on the Effective Technique of the CPR in Two Modes of the Device Warning Being On and Off.

Out-of-hospital cardiac arrest is a major public health problem with over 90% case fatality. Although it is known that good quality of cardiopulmonary Resuscitation (CPR) leads to improved patient outcomes, health care practitioners commonly perform sub-optimal CPR. The CPR feedback device is a small device designed to measure the number and depth of chest compressions (CC) and if the rate of compressions or the depth of the compressions is low or high, it will try to correct the CPR operation by announcing a warning to the resuscitator. The aim of this study was to evaluate the effectiveness of this device which was designed and made by the authors' technician study group member in improving CPR operations, to determine the need for it in all hospitals on a routine basis. This cross-sectional study was performed on patients who have suffered from cardio-pulmonary arrest in Al-Zahra Hospital in 2020. Patients needed primary CPR for any reason, were randomly divided into two groups using random allocation software. The first group contains patients as the CPR Feedback device is on and alarm is on and warns, if resuscitation is ineffective, the second group also uses the device, but with the difference that the alarm is off. The data was analyzed by general linear model method (repeated measure ANOVA). 80 patients were studied, including 63 men (79%) and 17 women (21%). Patients were divided among two groups. There was no significant difference in demographic characteristics between two groups. The results showed that there was no significant interaction between group and time for the compression depth variable and there was no significant difference in the depth of compressions between the two groups(P>0.05). For the rate of compressions, there was a significant interaction between group and time. These results indicate that turning on the CPR feedback device's warning increases the number of compressions during CPR and, as a result, makes it more effective. The between-group effect which showed the difference in the number of compressions in the two groups, was statistically significant (P<0.001). These results indicated that turning on the CPR feedback device's warning increases the rate of compressions during CPR and, as a result, makes it more effective. Therefore, the use of real-time CPR feedback device during chest compression in real-time CPR improves the quality of CPR.

Characterization of Infant Cardiopulmonary Resuscitation Delivery with Range Sensor Feedback on Performance

Cardiac arrest (CA) in infants is an issue worldwide, which causes significant morbidity and mortality rates. Cardiopulmonary resuscitation (CPR) is a technique performed in case of CA to save victims’ lives. However, CPR is often not performed effectively, even when delivered by qualified rescuers. Therefore, international guidelines have proposed applying a CPR feedback device to achieve high-quality application of CPR to enhance survival rates. Currently, no feedback device is available to guide learners through infant CPR performance in contrast to a number of adult CPR feedback devices. This study presents a real-time feedback system to improve infant CPR performance by medical staff and laypersons using a commercial CPR infant manikin. The proposed system uses an IR sensor to compare CPR performance obtained with no feedback and with a real-time feedback system. Performance was validated by analysis of the CPR parameters actually delivered against the recommended target parameters. Results show that the real-time feedback system significantly improves the quality of chest compression parameters. The two-thumb compression technique is the achievable and appropriate mechanism applied to infant subjects for delivering high-quality CPR. Under the social distancing constraints imposed by the SARS-CoV-2 pandemic, the results from the training device were sent to a CPR training center and provided each participant with CPR proficiency.

Application of Cardiopulmonary Resuscitation Mechanism in Infant Population: A Short Review

Cardiac arrest (CA) is a significant issue in infants worldwide, which causes disagreeable morbidity and mortality ratios. Thus, cardiopulmonary resuscitation (CPR) is a technique performed in case of cardiac arrest to save victims’ lives. The aim of CPR is to follow the blood flow promoting to the vital organs during the external chest provisional compressions. This technique has been reported to develop CA results. It was reported that CPR was not performed in high quality even when highly qualified rescuers delivered by CPR. Therefore, international guidelines have proposed for applying a CPR feedback device to release high-quality CPR to enhance survival rates. There is currently no feedback device available to guide learners through infant CPR performance compared to the adequate number of the adult in CPR feedback device. This study establishes a background knowledge to understand the CPR technique in infant populations by reviewing the following: the critical role of chest compression and rescue breath during the CPR process, the CPR standards, increasing the cardiac arrest survival rate by performing high-quality CPR, the effect of feedback on CPR performance., outlining the effect of different compression techniques on all the hemodynamic outcomes for delivering high-quality infant CPR.

Is a homemade cardiopulmonary resuscitation (CPR) trainer non-inferior to a commercially available CPR mannequin in teaching high-quality CPR? A non-inferiority randomized control trial

IntroductionStudies demonstrate that feedback devices help students achieve mastery of critical CPR skills and shorten the time from demonstration to competence. CPR feedback devices are costly and may not be available in low resource settings or in the context of online classes. We have developed a homemade feedback enabled CPR trainer. This trainer consists of a lid with two toilet rolls stacked on top. We have shown it is feasible to generate high quality CPR using this trainer, however the ability for this trainer to successfully be used in skill acquisition is unknown.Our main objective was to assess if learning CPR on a homemade toilet paper trainer was non-inferior to a commercially available mannequin when comparing post-training CPR scores. MethodsWe conducted a parallel non-inferiority randomized control trial using a variable block randomization to a 10-min training session on either a toilet paper or commercial mannequin trainer. Primary outcome was mean overall CPR score as determined by high fidelity mannequin software. A sample size of 62 per group was calculated based on a 90% power to assess for the lower limit of a two-sided 95% confidence interval above the non-inferiority limit of 10%. Results125 participants were randomized to the toilet paper (n = 64) or commercial mannequin trainer (n = 61). There was no difference between groups in age, sex, height, weight or previous CPR training. There was an absolute difference of 2% (CI 95% 3.3 to 7.3%) in mean overall CPR score between groups (toilet paper = 82% (SD 15.9%), commercial mannequin = 84% (SD 15%). ConclusionA homemade CPR trainer was non-inferior to a commercially available trainer. This study provides preliminary evidence supporting the use of a homemade, easily accessible trainer for basic compression-only CPR skill acquisition.

Quantification of Passive Ventilation Produced by Manual Chest Compressions Using a New Cardiopulmonary Resuscitation Feedback Device

AbstractSeveral studies have shown that chest compressions (CC) alone may produce in addition to blood circulation, a short-term passive ventilation. However, it is not clear whether high CC quality may produce in even greater amount of ventilation volumes. The aim of this study was to evaluate whether CC, using a new feedback device, can produce a substantial and sustainable passive volumes compared to standard CC. Thirty inexperienced volunteers performed CC for 2 min on a developed thoracic lung model and using a new feedback device. Participants were randomized into two groups that performed either CC with feedback first, followed by a trial without feedback, or vice versa. Efficient compression rate (correct CC rate and depth simultaneously) was significantly higher in feedback session (43.6% versus 25.5%; P = 0.006). As well, CC rate and depth efficiency were improved with feedback. Moreover, average tidal volumes and minute volumes that occurred during CC alone were significantly improved in feedback session (79.8 ± 5 ml versus 72.9 ± 7 ml) and (8.8 l/min versus 7.9 l/min), respectively (P &amp;lt; 0.001). Yet, no significant difference was found between the first and the 90th second interval (9.04 l/min versus 8.68 l/min, P = 0.163) in the feedback session. Conversely, a significant difference was evident after the first 15th seconds interval without feedback (8.77 l/min initially versus 8.38 l/min; P = 0.041). This study revealed that the new CPR feedback device improved CC quality in inexperienced volunteers. As well, the passive ventilation volumes were significantly increased and sustained when the device was used.

Comparing Real-Time Feedback Modalities to Support Optimal Cardiopulmonary Resuscitation for Undergraduate Nursing Students: A Quasi-Experimental Cross-Over Simulation Study

BackgroundOptimal cardiopulmonary resuscitation (CPR) is reliant on a chain of well performed interventions and skills. To investigate whether CPR feedback devices improve performance for nursing students, the effects of three feedback modalities—visual: Laerdal SimPad®; visual-embodied metaphoric: Innosonian Brayden Pro®; and visual-audio: Physio-Control TrueCPR®—was tested. MethodA quasi-experimental cross-over study compared performance metrics of participant exposure to three feedback modalities and standard adult basic life support (BLS) without feedback in a simulated environment. After baseline training, 64 participants performed adult single-rescuer BLS on a manikin for each modality and without feedback for two minutes. Effective chest compressions (correct depth, thoracic recoil, pressure point, rate, no-flow fraction) and ventilation parameters were compared using Friedman and Wilcoxon tests. ResultsSuperior technical accuracy in CPR skills performance was evident with all feedback modalities when compared with no feedback p = <.05); visual-audio feedback (TrueCPR®) was most effective (p = .005). Participants demonstrated higher technical accuracy in CPR performance (30:2 cycles; chest compression number/rate/depth; chest recoil; pressure point; correct number of ventilations) when compared with no feedback (p = .0001), despite achieving national certification three weeks before data collection. ConclusionThis appears to be the first study to explore the use of feedback modalities during CPR performance in nursing students. These feedback devices can play a major role in improving measurable parameters of BLS and psychomotor skill capability. Modalities varied in their ability to improve performance; visual-audio feedback significantly improved chest compressions, ventilation and cycle performance, whereas visual-graph–based feedback improved flow fraction and ventilations.

Effect of Audiovisual Cardiopulmonary Resuscitation Feedback Device on Improving Chest Compression Quality

The one month survival rate after out-of-hospital cardiac arrest (OHCA) in the paediatric population remains low. Improving survival in paediatric OHCA by enhancing the quality of cardiopulmonary resuscitation (CPR) is important. In this study, we aimed to analyse the factors associated with CPR quality by using a real-time feedback device. Participants were prospectively divided into 4 groups: paediatric research fellows, paediatric residents, medical students (clerks), and paediatric critical care nurses. Then, the participants were asked to perform 5 cycles of CPR on a paediatric simulation manikin without prompts from feedback devices, and to repeat another 5 cycles of CPR after education with the 2015 paediatric advanced life support guidelines. A total of 75 participants were evaluated. In the overall analysis, an improvement in the percentage of participants meeting the target compression rate was observed (from 49.82% to 71.23%, P < 0.001). The percentage of participants achieving the target compression depth improved from 73.77% to 85.63% (P = 0.005). Among the 4 groups, the residents showed the most significant improvement in both compression rate (from 48.41% to 86.57%, P < 0.001) and compression depth (from 63.50% to 95.57%, P < 0.001). Inappropriate rate was a more important factor resulting in inadequate CPR performance than inappropriate depth. An excessive compression rate was also a common problem. In conclusions, the real-time CPR feedback device may help clinical physicians and nurses in improving the quality of chest compression. Excessive CPR compression rate may be a major cause of inadequate CPR performance.

Improving paediatric cardiac arrest outcomes: cpr quality improvement collaborative (CPR-QUIC)

Introduction: Cardiopulmonary Resuscitation (CPR) guidelines recommend target values for selected CPR parameters related to rate and depth of chest compressions. International experts in resuscitation science have incorporated real-time CPR feedback into clinical practice and have demonstrated improved functional outcomes after cardiac arrest. Recent technological developments using accelerometer-based measurements incorporated into defibrillator systems, allow for real-time monitoring and feedback of CPR quality during resuscitation attempts. Aims: To improve the quality of CPR delivered to cardiac arrest patients in a paediatric intensive care unit (PICU) using defibrillators with real-time CPR feedback. To determine the association between quantitative CPR measures and patient outcomes after cardiac arrest. Methods: A bedside resuscitation training program was designed for the implementation of real-time CPR feedback devices. Medical and nursing staff were taught to interpret CPR metrics (depth and rate) on task trainers and CPR quality feedback training was incorporated into simulation-based education. Real-time CPR feedback technology was implemented in February 2019 and quantitative chest compression data was collected on all cardiac arrests in PICU. The data from each CPR event, metrics and time to defibrillation, was analysed. The arrest event data was reported to an international study collaborative to help determine the association between chest compression mechanics and patient outcomes. Results: Real-time CPR feedback used during resuscitation training improved staff performance. Since implementation, real-time CPR feedback was used in four arrest events and all patients survived to discharge from intensive care. The implementation of the project led to the standardisation of resuscitation training, cardiac arrest management and facilitated local process change within the PICU. Conclusion: We were the first institution in Australia to report paediatric cardiac arrest data for international benchmarking to improve patient outcomes after cardiac arrest. The CPR data collected provided objective feedback to resuscitation teams and guided training in order to improve performance.

Use of Capnography and Cardiopulmonary Resuscitation Feedback Devices Among Prehospital Advanced Life Support Providers.

Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting. The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices. Prehospital agencies that provide ALS services in NYS were identified using an online registry. Managers in these agencies were contacted by electronic mail and asked to complete a questionnaire regarding their agency's experience with capnography and CPR feedback devices. The questionnaire included questions on the availability of capnography and CPR feedback devices, the existence of clinical protocols for using capnography, and provider opinion on the utility of capnography and CPR feedback devices for improving pediatric resuscitation. Of 710 ALS agencies, 238 (33.5%) completed the survey. Ninety-five percent and 24% of agencies reported having capnography and CPR feedback devices available aboard ambulances, respectively. Ninety-seven percent of agencies reported having capnography clinical protocols for endotracheal intubation, 63% for return of spontaneous circulation, and 54% for guiding CPR. Forty-seven percent agreed that capnography improves outcomes in the resuscitation of pediatric patients, whereas 51% of providers were neutral and 2% disagreed. Capnography is available in most NYS ALS agencies surveyed. Cardiopulmonary resuscitation feedback devices are less common. Protocols for the use of capnography mainly focused on endotracheal intubation and less for the recognition of return of spontaneous circulation and for guiding CPR. Half of the providers surveyed were neutral on whether capnography improves outcomes in the resuscitation of pediatric patients.

Real-time feedback, debriefing, and retraining system of cardiopulmonary resuscitation for out-of-hospital cardiac arrests: a study protocol for a cluster parallel-group randomized controlled trial

BackgroundThe quality of cardiopulmonary resuscitation (CPR) performed by emergency medical services (EMS) personnel affects patient outcomes after cardiac arrest. A CPR feedback device with an accelerometer mounted on a defibrillator can monitor the motion of the patient’s sternum to display and record CPR quality in real time. To evaluate the utility of real-time feedback, debriefing, and retraining using a CPR feedback device outside of the hospital, an open-label, cluster randomized controlled trial will be conducted in five municipalities of Osaka Prefecture, Japan.MethodsEach EMS station within a fire department will be randomly assigned to: 1) the treatment group with real-time feedback, debriefing, and retraining using the CPR feedback device (intervention group); or 2) the conventional treatment group without real-time feedback, debriefing, and retraining (control group). This trial will include 2850 to 3020 patients over about 4 years. The primary outcome of the trial is 1-month favorable neurological survival, defined as cerebral performance category scale score 1 or 2. Secondary outcomes are 1-month survival, survival to hospital discharge, return of spontaneous circulation, and quality of CPR including fraction, depth, tempo, and ventilation rate.DiscussionThe trial will assess whether treatment monitored by the CPR feedback device, which allows for real-time feedback, debriefing, and retraining using CPR quality data, outperforms conventional treatment without real-time feedback, debriefing, and retraining in terms of 1-month favorable neurological survival in cardiac arrest patients receiving CPR outside the hospital.Trial registrationUniversity Hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000021431. Registered on 11 March 2016.

Monitoring chest compression quality during cardiopulmonary resuscitation: Proof-of-concept of a single accelerometer-based feedback algorithm

BackgroundThe use of real-time feedback systems to guide rescuers during cardiopulmonary resuscitation (CPR) significantly contributes to improve adherence to published resuscitation guidelines. Recently, we designed a novel method for computing depth and rate of chest compressions relying solely on the spectral analysis of chest acceleration. That method was extensively tested in a simulated manikin scenario. The purpose of this study is to report the results of this method as tested in human out-of-hospital cardiac arrest (OHCA) cases.Materials and methodsThe algorithm was evaluated retrospectively with seventy five OHCA episodes recorded by monitor-defibrillators equipped with a CPR feedback device. The acceleration signal and the compression signal computed by the CPR feedback device were stored in each episode. The algorithm was continuously applied to the acceleration signals. The depth and rate values estimated every 2-s from the acceleration data were compared to the reference values obtained from the compression signal. The performance of the algorithm was assesed in terms of the sensitivity and positive predictive value (PPV) for detecting compressions and in terms of its accuracy through the analysis of measurement error.ResultsThe algorithm reported a global sensitivity and PPV of 99.98% and 99.79%, respectively. The median (P75) unsigned error in depth and rate was 0.9 (1.7) mm and 1.0 (1.7) cpm, respectively. In 95% of the analyzed 2-s windows the error was below 3.5 mm and 3.1 cpm, respectively.ConclusionsThe CPR feedback algorithm proved to be reliable and accurate when tested retrospectively with human OHCA episodes. A new CPR feedback device based on this algorithm could be helpful in the resuscitation field.

A better understanding of ambulance personnel's attitude towards real-time resuscitation feedback.

High-quality chest compressions during cardiopulmonary resuscitation (CPR) play a significant role in surviving cardiac arrest. Chest-compression quality can be measured and corrected by real-time CPR feedback devices, which are not yet commonly used. This article looks at the acceptance of such systems in comparison of equipped and unequipped personnel. Two groups of emergency medical services' (EMS) personnel were interviewed using standardized questionnaires. The survey was conducted in the German cities Dortmund and Münster. Overall, 205 persons participated in the survey: 103 paramedics and emergency physicians from the Dortmund fire service and 102 personnel from the Münster service. The staff of the Dortmund service were not equipped with real-time feedback systems. The test group of equipped personnel of the ambulance service of Münster Fire brigade uses real-time feedback systems since 2007. What is the acceptance level of real-time feedback systems? Are there differences between equipped and unequipped personnel? The total sample is receptive towards real-time feedback systems. More than 80% deem the system useful. However, this study revealed concerns and prejudices by unequipped personnel. Negative ratings are significantly lower at the Münster site that is experienced with the use of the real-time feedback system in contrast to the Dortmund site where no such experience exists-the system's use in daily routine results in better evaluation than the expectations of unequipped personnel. Real-time feedback systems receive overall positive ratings. Prejudices and concerns seem to decrease with continued use of the system.

Kardiyopulmoner resüsitasyon eğitimi eğitimsiz kurtarıcıların acil yanıt sistemi görevlisi kılavuzluğunda uyguladığı temel yaşam desteğinin kalitesini arttırmaktadır

Objective : The people who aid patients in cardiac arrest in daily life are those who witness the event in the immediate environment. In cases of cardiac arrest, which anyone can encounter at any time and place, the application of correct and efficient basic life support by bystanders contributes significantly to the patient’s survival. In this study, our aim was to compare the efficiency of cardiopulmonary resuscitation (CPR) by untrained lay rescuers assisted by a dispatcher with CPR by the same persons without assistance from a dispatcher after they are provided with CPR training. Material and Methods : We planned the study prospectively on 5th year students of the Baskent University Faculty of Dentistry. We placed each study participant one by one in a room where there was a model of basic life support (BLS) and a CPR feedback device. We provided participants with a scenario of BLS taking place in a public space. At that time, we contacted a dispatcher who was standing in another room. We asked participants to apply one 2-min cycle of CPR consisting only of chest compression with the dispatcher’s assistance. After we recorded data on all participants, we provided them BLS training. We re-evaluated all participants’ CPR abilities immediately after this. Results : Thirty-seven 5th year Faculty of Dentistry students participated in our study. The median age of participants was 23.22±1.31. The gender distribution was 16.2% male and 83.7% female. There was a statistically significant difference between the number of chest compressions applied before (89.27±24.53) and after training (110.59±21.92) ( p <0.001). There was a statistically significant difference between the measurements of compression times, the ratio of proper compressions to all compressions, and the compression percentages before and after training ( p <0.005; <0.005 and <0.001 respectively). Conclusion : The results of our study clearly reveal that the CPR applied by trained laypersons is distinctly superior to CPR with the assistance of a dispatcher.

Paramedic-reported barriers towards use of CPR feedback devices in Perth, Western Australia

Feedback devices for cardiopulmonary resuscitation (CPR) have been introduced across a number of emergency medical services (EMS) worldwide with the intention of increasing the provision of high quality CPR. In July 2014, St. John Ambulance Western Australia (SJA-WA) introduced the Q-CPRTM device into mandatory clinical practice; however usage rates were lower than expected. Methods: A voluntary, anonymous survey was issued to a convenience sample of SJA-WA paramedics from September to December 2015 to determine the paramedic-reported barriers towards the use of Q-CP Results: Of the 264 paramedics who participated in the survey, 41% reported having used Q-CPR during their last attempted resuscitation. Among those who had not used it, the reason most commonly cited (37%) was that a mechanical chest compression device arrived on scene prior to the Q-CPR being deployed. Secondly, other interventions were prioritized above the use of Q-CPR (20%). Thirdly, pain associated with use of the Q-CPR prevented its utilization in 17% of cases. Other reasons were less frequently reported. Conclusion: Lower usage rates appeared to be primarily linked to the utilisation of other equipment and interventions in preference to the Q-CPR and to a lesser extent due to pain associated with the use of such devices.

COMPARISON OF STANDARD CPR AND CPR FEEDBACK METHODS IN TERMS OF THE EFFECTIVENESS OF CHEST COMPRESSIONS DURING CARDIOPULMONARY RESUSCITATION: A RANDOMIZED CONTROLLED STUDY

Objectives & BackgroundThe primary purpose of the study was to compare the metrics on the effectiveness of chest compressions obtained through an advanced CPR (cardiopulmonary resuscitation) manikin and a real-time...

Cardiopulmonary resuscitation quality and beyond: the need to improve real-time feedback and physiologic monitoring.

High-quality cardiopulmonary resuscitation (CPR) has been shown to improve survival outcomes after cardiac arrest. The current standard in studies evaluating CPR quality is to measure CPR process measures—for example, chest compression rate, depth, and fraction. Published studies evaluating CPR feedback devices have yielded mixed results. Newer approaches that seek to optimize CPR by measuring physiological endpoints during the resuscitation may lead to individualized patient care and improved patient outcomes.

Effect of the Cardio First Angel™ device on CPR indices: a randomized controlled clinical trial.

BackgroundA number of cardiopulmonary resuscitation (CPR) adjunct devices have been developed to improve the consistency and quality of manual chest compressions. We investigated whether a CPR feedback device would improve CPR quality and consistency, as well as patient survival.MethodsWe conducted a randomized controlled study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical intensive care units of four academic teaching hospitals. Patients were randomized to receive either standard manual CPR or CPR using the Cardio First Angel™ CPR feedback device. Recorded variables included guideline adherence, CPR quality, return of spontaneous circulation (ROSC) rates, and CPR-associated morbidity.ResultsA total of 229 subjects were randomized; 149 were excluded; and 80 were included. Patient demographics were similar. Adherence to published CPR guidelines and CPR quality was significantly improved in the intervention group (p < 0.0001), as were ROSC rates (72 % vs. 35 %; p = 0.001). A significant decrease was observed in rib fractures (57 % vs. 85 %; p = 0.02), but not sternum fractures (5 % vs. 17 %; p = 0.15).ConclusionsUse of the Cardio First Angel™ CPR feedback device improved adherence to published CPR guidelines and CPR quality, and it was associated with increased rates of ROSC. A decrease in rib but not sternum fractures was observed with device use. Further independent prospective validation is warranted to determine if these results are reproducible in other acute care settings.Trial registrationClinicalTrials.gov identifier: NCT02394977. Registered on 5 Mar 2015.