Effects of metronome use on cardiopulmonary resuscitation quality

Abstract

OBJECTIVE: Whether the use of metronome affects the quality of cardiopulmonary resuscitation (CPR) remains unclear. In this study, we investigated the effect of metronome use on CPR quality. METHODS: This was a prospective, simulation-based CPR manikin study. There were two phases: without and with metronome use. Chest compression was performed for 2 min, and three CPR quality criteria including chest compression depth, recoil, and rate were recorded with TrueCPR Feedback Device in both phases. RESULTS: In all, 102 resident physicians were included. The achievement of optimal chest compression depth and complete recoil was better with metronome use than without (83% and 77% vs. 78% and 39%, P ≤ 0.001, respectively). Optimal chest compression rate was also reached with metronome use because the range of the compression rate was closer to the normal limits than those without metronome use (110 [interquartile range (IQR) 109–113] vs. 120 [IQR 109–129], P ≤ 0.001). Of all the participants, 70.6% stated that metronome use had a positive effect on their performance during the CPR application and 66.7% stated that they wished to use the metronome in their daily practice. CONCLUSION: Using a metronome during simulation-based CPR improved the compression depth and recoil by fixing chest compression rate. We suggested that metronome should be used in CPR trainings of health-care professionals.

Usefulness of an auditory aid to improve chest compression rate accuracy during cardiopulmonary resuscitation

“…[8][9][10][12][13][14][15][16][17][18][19][20] The auditory aid provides a tempo for compression rate administration and has been shown to improve compression rate accuracy when used during training and clinical practice of both lay persons and human medical personnel. [8][9][10][12][13][14][15][16][17][18][19][20] Additionally, auditory aids have been found to help prevent deterioration of chest compression rate associated with fatigue over time. 8,12,15 A traditional metronome is a low-cost and readily available device, which may be used as an auditory aid.…”

“…Alternatively, several popular songs with beat counts between 100 and 120 per minute may be used as an auditory aid with the beat of the song providing a cadence for compression rate administration by rescuers. [8][9][10][12][13][14][15][16][17][18][19][20]22 Human guidelines are supportive for the use of auditory guidance during CPR to aid adherence and delivery of high-quality CPR; however, at present, there is no consensus on the optimal auditory aid rate and type. 2,23 Popular songs with beat counts between 100 and 120 per minute can inspire recall for the rate of compressions, even when not audible.…”

“…One method to improve compression rate accuracy during CPR is to use an auditory aid for guidance 8–10,12–20 . The auditory aid provides a tempo for compression rate administration and has been shown to improve compression rate accuracy when used during training and clinical practice of both lay persons and human medical personnel 8–10,12–20 .…”

“…The traditional metronome produces clear beats set at a specific rate as determined by the operator with the rescuer instructed to deliver compressions at the same rate to that of the metronome. Alternatively, several popular songs with beat counts between 100 and 120 per minute may be used as an auditory aid with the beat of the song providing a cadence for compression rate administration by rescuers 8–10,12–20,22 . Human guidelines are supportive for the use of auditory guidance during CPR to aid adherence and delivery of high‐quality CPR; however, at present, there is no consensus on the optimal auditory aid rate and type 2,23 …”

Metronome use improves achievement of a target compression rate in out-of-hospital cardiac arrest: A retrospective analysis

“…The use of audio or visual devices can improve compliance with chest compression rate targets. [7] , [8] , [9] , [10] , [11] Devices that provide real-time audio or visual feedback, including prompts, have been evaluated in multiple simulation-based studies, as well as some clinical studies, with consistent improvement in compression rates for both laypersons and medical providers. 7 Simulation studies using a simple audio-based metronome only, without other prompts, also improved compression parameters.…”