Effective compression ratio—A new measurement of the quality of thorax compression during CPR

Greif, Robert; Stumpf, Dominik; Neuhold, Stephanie; Theiler, Lorenz; Hochbrugger, Eva; Haider, Dominik G.; Rinösl, Harald; Fischer, Henrik

doi:10.1016/j.resuscitation.2012.10.016

Cited by 13 publications

(5 citation statements)

References 20 publications

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“…Several CPR scores including the QCPR score are currently used [21]. The QCPR score was previously validated and used in many studies [12,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Iskrzycki¹,

Smereka²,

Núñez³

et al. 2018

Kardiol Pol

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A b s t r a c tBackground: Drowning is a common issue at many pools and beaches, and in seas all over the world. Lifeguards often act as bystanders, and therefore adequate training in high-quality cardiopulmonary resuscitation (CPR) and use of adequate equipment by lifeguards is essential. Aim:The aim of this study was to evaluate the impact of the recently introduced CPRMeter (Laerdal, Stavanger, Norway) on quality of CPR, if used by moderately experienced CPR providers. In particular, we tested the hypothesis that using the CPRMeter improves quality of chest compression by lifeguards compared to standard non-feedback CPR. Methods:The study was designed as prospective, randomised, cross-over manikin trial. Fifty lifeguards of the Volunteer Water Rescue Service (WOPR), a Polish nationwide association specialised in water rescue, participated in this study. Participants were randomly assigned 1:1 to one of two groups: a feedback group and a non-feedback group. Participants swim a distance of 25 m in the pool, and then they were asked to haul a manikin for the second 25 m, simulating rescuing a drowning victim. Once participants finished the second 25-m distance, participants were asked to initiate 2-min basic life support according to the randomisation. Results:The median quality of CPR score for the 2-min CPR session without feedback was 69 (33-77) compared to 84 (55-93) in the feedback group (p < 0.001). Compression score, mean depth, rate of adequate chest compressions/min, and overall mean rate during the CPR session improved significantly in the feedback group, compared to the non-feedback group. Conclusions:Using the visual real-time feedback device significantly improved quality of CPR in our relatively unexperienced CPR providers. Better quality of bystander CPR is essential for clinical outcomes, and therefore feedback devices should be considered. Further clinical studies are needed to assess the effect of real-time visual devices, especially in bystander-CPR.

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“…Several CPR scores including the QCPR score are currently used [21]. The QCPR score was previously validated and used in many studies [12,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Iskrzycki¹,

Smereka²,

Núñez³

et al. 2018

Kardiol Pol

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“…In 10 of the selected papers, it was proposed that CPR quality should be defined as the percentage of compressions that met simultaneously all criteria defined by the authors (various criteria in different papers) [4][5][6][7][8][9][10][11][12][13].…”

Section: Resultsmentioning

confidence: 99%

“…Only three papers presented a mathematical formula that could have been used for further comparison and detailed analysis [13][14][15]. In two publications the authors assumed that "CPR is excellent" when more than 90% of compressions fulfilled the criteria of optimal CC rate and depth as well as chest recoil [16,17].…”

Section: Resultsmentioning

confidence: 99%

Assessment of Chest Compression Quality — a systematic review

Kłosiewicz

Puslecki

Zalewski

et al. 2020

Disaster Emerg Med J

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INTRODUCTION: High-quality chest compression (CC) is a crucial factor that determines the survival of cardiac arrest patients. Adequate quality should be featured by appropriate compression rate and depth, and full chest recoil after each compression. The ranges are strictly determined in Resuscitation Guidelines. All these parameters are interdependent. Currently, there is a need to find or develop a universal index that will enable the definition and determination of the overall quality of CCs. MATERIAL AND METHODS: A systematic review of the MEDLINE, EMBASE, COCHRANE, and GOOGLE SCHOLAR databases was performed. The authors aimed to find papers in which the quality of CC was assessed. The extracted information included measurement of the CC quality in a direct and objective manner-by analysing the depth, rate, and recoil of CC, position of the hands, duty cycle, and indirectly by evaluating chest compression fraction (CCF). Papers describing the quality of CC based on a combination of various components of the CC quality were selected for analysis. RESULTS: In total 1604 publications were obtained. Among them, 21 articles satisfied the search criteria. In most of the papers, it was suggested that compressions should have been considered as correct when they met simultaneously all quality criteria. Only three papers presented any mathematical formula that could have been used for further comparisons. CONCLUSIONS: Although many proposals have been developed, no single, universal, and commonly accepted indicator of resuscitation quality has been so far designed and subsequently applied. Further work on this subject is warranted and strongly recommended.

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“…After assignment to the group, students were put into pairs according to the assignment of randomised codes. Prior to study measurements, all participants received initial training using a modified 4-stage approach [ 16 , 17 ]: following a standardised video according to their group, students were allowed to practice their basic life support (BLS) scenario under supervision until they felt sufficiently confident with the method. The duration of the training videos and the free practice differed between the different groups.…”

Section: Methodsmentioning

confidence: 99%

“…Effective compression ratio (ECR), a parameter combining correct hand position, chest compression depth, and complete decompression multiplied by flow-time fraction, which has recently been established to assess quality of CPR, was defined as the primary outcome parameter [ 16 ]. The primary hypothesis to be tested was that there is no difference in ECR between the groups sCPR, hfCPR and mfCPR.…”

Section: Methodsmentioning

confidence: 99%

Short structured feedback training is equivalent to a mechanical feedback device in two-rescuer BLS: a randomised simulation study

Pávó

Goliasch

Nierscher

et al. 2016

Scand J Trauma Resusc Emerg Med

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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.

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Effective compression ratio—A new measurement of the quality of thorax compression during CPR

Cited by 13 publications

References 20 publications

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation

Assessment of Chest Compression Quality — a systematic review

Short structured feedback training is equivalent to a mechanical feedback device in two-rescuer BLS: a randomised simulation study

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