Cardiopulmonary resuscitation feedback improves the quality of chest compression provided by hospital health care professionals

Pozner, Charles N.; Almozlino, Adam; Elmer, Jonathan; Poole, Stephen; McNamara, De'ann; Barash, David

doi:10.1016/j.ajem.2010.01.008

Cited by 72 publications

(49 citation statements)

References 35 publications

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“…The use of objective real-time chest compression quality feedback or post-scenario quantitative debriefing of CPR quality using objective measures may ameliorate this deficiency and concurrently reduce the cognitive load of instructors. Studies have shown that real-time CPR feedback improves performance, [23][24][25] and the AHA suggests considering the use of real-time feedback 11 and formalized post-resuscitation debriefing. 2 Various devices other than high-fidelity manikins have been used to assess chest compression quality in simulated resuscitation, including metronomes and smartphones.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Brennan

McGraw

Brooks

2016

CJEM

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Objectives: The 2010 American Heart Association Guidelines stress the importance of high quality cardiopulmonary resuscitation (CPR) as a predictor of survival from cardiac arrest. However, resuscitation training is often facilitated and evaluated by instructors without access to objective measures of CPR quality. This study aims to determine whether instructors experienced in the area of adult resuscitation (emergency department staff and senior residents) can accurately assess the quality of chest compressions as a component of their global assessment of a simulated resuscitation scenario. Methods: This is a prospective observational study in which objective chest compression quality data (rate, depth, and fraction) were collected from the simulation manikin and compared to subjective instructor assessment. Data were collected during weekly simulation training sessions for residents, medical students, and nursing students. Results: We included data from 24 simulated resuscitation scenarios assessed by 1 of 15 instructors. Subjective assessment of chest compression quality identified an adequate compression rate (100-120 compressions per minute) with a sensitivity of 0.17 (confidence interval [CI] 0.02-0.32) and specificity of 0.06 (CI −0.04-0.15), adequate depth (>50 mm) with a sensitivity of 0 and specificity of 0.38 (CI 0.18-0.57), and adequate fraction (>80%) with a sensitivity of 1 and a specificity of 0.25 (CI 0.08-0.42). Conclusion: Instructor assessment of chest compression rate, depth, and fraction demonstrates poor sensitivity and specificity when compared to the data from the simulation manikin. These results support the use of objective and technologically supported measures of chest compression quality for feedback during resuscitation education using simulators. RÉSUMÉObjectif: Dans les lignes directrices de 2010 de l'American Heart Association, on insiste sur l'importance de la qualité de la réanimation cardiopulmonaire (RCP) comme facteur prévisionnel de survie à un arrêt cardiaque. Toutefois, les séances de formation de réanimation sont souvent données et évaluées par des instructeurs, sans mesure objective de la qualité de la RCP. L'étude visait à déterminer si les instructeurs expérimentés dans le domaine de la réanimation chez les adultes (personnel au service des urgences, résidents séniors) pouvaient évaluer avec exactitude la qualité des compressions thoraciques, et ce, comme l'un des éléments de l'évaluation globale de scénarios de réanimation. Méthode: Il s'agit d'une étude d'observation prospective, dans laquelle il y a eu collecte de données objectives sur la qualité des compressions thoraciques (fréquence, profondeur, fraction) à partir de simulations sur mannequin, et comparaison avec l'évaluation subjective des instructeurs. Les données ont été recueillies durant les séances hebdomadaires de simulation, préparées à l'intention des résidents, des étudiants en médecine et des étudiants en soins infirmiers. Résultats: Les données recueillies provenaient de 24 séances de simula...

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Section: Discussionmentioning

confidence: 99%

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Brennan

McGraw

Brooks

2016

CJEM

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“…It has been well demonstrated that feedback devices improve health care providers' CPR quality during both training [17][18][19][20][21][22][23][24] and in real-life scenarios. 25 ILCOR 2015 recommendations pointed out the importance of high-quality CPR performed not only by health care providers but also by laypersons, who are often the first bystanders in the setting of OHCA.…”

Section: Current Evidences About the Feedback Devicesmentioning

confidence: 99%

“…15 Instructor assessment of chest compression quality during training has been demonstrated to be not accurate enough. 16 For this reason, in the last few years, many types of CPR feedback devices have been developed, and their use has been demonstrated to increase the quality of health care providers' CPR during both training [17][18][19][20][21][22][23][24] and in real-life cardiac arrest scenarios. 25 Recent evidence has also shown that real-time audiovisual feedback used during a real cardiac arrest increases the survival rate and the chances of a favourable outcome following OHCA.…”

Section: Introductionmentioning

confidence: 99%

Real-time visual feedback during training improves laypersons’ CPR quality: a randomized controlled manikin study

Baldi

Cornara

Epis

et al. 2017

CJEM

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Objective: The chances of surviving an out-of-hospital cardiac arrest depend on early and high-quality cardiopulmonary resuscitation (CPR). Our aim is to verify whether the use of feedback devices during laypersons' CPR training improves chest compression quality. Methods: Laypersons totalling 450 participating in Basic Life Support and Automated External Defibrillation (BLS/ AED) courses were randomly divided into three groups: group No Feedback (NF) attended a course without any feedback, group Short Feedback (SF) a course with 1-minute training with real-time visual feedback, and group Long Feedback (LF) a course with 10-minute training with real-time visual feedback. At the end of each course, we recorded 1 minute of compression-only CPR. The primary end point was the difference in the percentage of compressions performed with correct depth. Results: There was a significant improvement in the percentage of compressions with correct depth in the groups receiving feedback compared to the other (NF v. LF, p = 0.022; NF v. SF, p = 0.005). This improvement was also present in the percentage of compressions with a complete chest recoil (71.7% in NF, 86.6% in SF, and 88.8% in LF; p < 0.001), compressions with the correct hand position (93.2% in NF, 98.2% in SF, and 99.3% in LF; p < 0.001), and in the Total CPR Score (79.4% in NF, 90.2% in SF, and 92.5% in LF; p < 0.001). There were no significant differences for all of the parameters between group SF and group LF. Conclusions: Real-time visual feedback improves laypersons' CPR quality, and we suggest its use in every BLS/AED course for laypersons because it can help achieve the goals emphasized by the International Liaison Committee on Resuscitation recommendations. RÉSUMÉObjectif: Les chances de survie à la suite d'un arrêt cardiaque survenu dans la collectivité dépend de la rapidité des manoeuvres de réanimation cardiorespiratoire (RCR) ainsi que de leur qualité. L'étude décrite ici visait à vérifier si l'utilisation de dispositifs de rétroaction durant la formation des profanes en la matière pouvait améliorer la qualité des compressions thoraciques. Méthode: Ont participé à des cours de réanimation de base et de défibrillation 450 profanes en la matière, divisés au hasard en trois groupes : le premier a suivi le cours sans rétroaction (SR) aucune; le deuxième a suivi le cours avec une brève rétroaction (BR), soit 1 minute de formation avec une rétroaction visuelle en temps réel; et le troisième a suivi le cours avec une longue rétroaction (LR), soit 10 minutes de formation avec une rétroaction visuelle en temps réel. À la fin de chacun des cours, il y a eu enregistrement des compressions seules durant 1 min. Le principal critère d'évaluation était les différences de pourcentage quant aux compressions réalisées à la bonne profondeur. Résultats: Une amélioration sensible du pourcentage des compressions réalisées à la bonne profondeur a été observée dans les groupes dans lesquels il y avait eu de la rétroaction comparativement à celui qui n'en avait pas reç...

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“…However, the proportion of adequate compression depth was significantly higher in the first group, and this result is consistent with previous data. 12,13 Another important observation was the fact that the mean compression depth and proportion of adequate compression declined over time. It is well known that rescuer's fatigue adversely affects the quality of chest compression when performed without interruption for over 3 minutes, especially in female.…”

Section: 0mentioning

confidence: 99%

A Randomised, Cross over Study Using a Mannequin Model to Evaluate the Effects on CPR Quality of Real-Time Audio-Visual Feedback Provided by a Smartphone Application

Park

Kang

Heo

et al. 2014

Hong Kong Journal of Emergency Medicine

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Objective:To evaluate the effect of real time feedback provided by smartphone application on cardiopulmonary resuscitation (CPR) performance. Methods: Participants were randomised in two groups based on whether chest compression with or without the assistance of the smartphone application. Both groups performed hands-only CPR on a mannequin for 4 minutes. Data on CPR performance of both groups was compared. To assess the reliability the feedback value, we compared the CPR data from Skillmeter and data from smartphone. A questionnaire survey to participants about the usefulness of the application was also evaluated. Results: Twenty-one subjects were recruited for the study. We found no significant difference in mean chest compression rate (103.35.0/min vs. 107.11.7/min; p=0.133) and depth between the two groups (47.3 [39.3, 56.2] mm vs. 45.8 [40.3, 49.9] mm; p=0.085). The proportion of adequate compression depth over the total compression was significantly higher in the group using the smartphone (38.1% vs. 22.2%; p=0.034). The CPR data displayed on smartphone application in mannequin's chest was not different from Skillmeter software. The majority of the participants considered the application easy to use, but holding the smartphone during CPR hampered compression. Conclusions: Real-time audio-visual feedback on CPR depth and rate using a smartphone application can help to maintain the adequate chest compression depth in prolonged CPR. A better method to hold the smartphone may maximise the feedback effect on CPR quality. (Hong Kong j.emerg.med. 2014;21:153-160) 目的：探討智能手機應用程式實時反饋對 CPR 表現的影響。方法：受試者根據是否使用智能手機應用程式幫助胸部按壓隨機分為兩組。兩組在人體模型進行心肺復甦術 4 分鐘。比較兩組的 CPR 表現數據。為了評估反饋的可靠性，我們比較了 Skillmeter 和智能手機的 CPR 數據。以問卷調查，了解參與者對應用程式實用性的評價。結果：二十一受試者納入研究。我們發現兩組之間在平均胸部按壓率（ 103

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Cardiopulmonary resuscitation feedback improves the quality of chest compression provided by hospital health care professionals

Cited by 72 publications

References 35 publications

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Accuracy of instructor assessment of chest compression quality during simulated resuscitation

Real-time visual feedback during training improves laypersons’ CPR quality: a randomized controlled manikin study

A Randomised, Cross over Study Using a Mannequin Model to Evaluate the Effects on CPR Quality of Real-Time Audio-Visual Feedback Provided by a Smartphone Application

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