Objective: Many public access defibrillators (PAD) incorporate computer programs to provide audiovisual feedback to assist the user to deliver cardiopulmonary resuscitation (CPR) according to current international guidelines. This usability study assessed if a PAD integrated with a real-time audiovisual CPR feedback system can guide lay-users to optimum chest compression rates, and if it is detrimental to chest compression depth. Methods: Randomly selected volunteers (15+ years) were recruited for two experiments. Experiment 1 (n=156) assessed the time taken to achieve the "Good speed" audio prompt (i.e. perform compressions at a rate of 100-120 compressions per minute) and chest compression fraction (CCF). Experiment 2 (n=140) assessed the effect of rate-only CPR feedback on chest compression depth. Two devices of the same model were used, one with CPR rate feedback, and the other with CPR feedback disabled. The difference in compression depths and CCF were assessed. Results: Experiment 1: A total of 136 (87.2%) participants achieved "Good speed" within 45 seconds with a mean CCF of 90.3% recorded. Experiment 2: The device with feedback lead to a mean (SE) depth of 24.61mm (0.99) compared to 20.08mm (0.96) for the feedback disabled device. ANCOVA analysis provided a mean significant difference (Standard Error; SE) of 4.52mm (1.38mm; p-value=0.001) favouring the device with CPR rate feedback. Conclusions: CPR rate-only feedback was not detrimental to chest compression depth and suggests rate-only feedback may improve compression depth. Significance: The incorporation of clear, intuitive, audiovisual CPR feedback systems can assist lay-users to optimise compression rates and maintain a high CCF.
In this porcine model of induced cardiac arrest moderate within animal correlations were observed between mechanical and physiological markers of chest compression efficacy demonstrating the challenge in utilising a single mechanical metric to quantify chest compression efficacy. ICG amplitude demonstrated strong within animal correlations with compression depth and ETCO2 suggesting its potential utility to provide CPR feedback in the out of hospital setting to improve performance.
High quality CPR in conjunction with early defibrillation can enhance survival outcomes following cardiac arrest. This usability study aimed to evaluate a novel prototype user interface of a public access defibrillator for the improvement of CPR during a simulated resuscitation attempt. Test candidates were asked to use the device in the absence of audible instructions, relying solely on the device membrane, to perform CPR chest compressions. The rate of the rescuer chest compression were then assessed and evaluated according to current resuscitation guidelines. All participants improved their rate of CPR within test. All but one achieved the correct compression rate within 20 seconds. This study suggests that the device interface could potentially enhance real-time CPR quality during resuscitation attempts.
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