The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest – A prospective, randomized trial

Böhn, Andreas; Weber, Thomas P.; Wecker, Sascha; Harding, U.; Osada, Nani; Aken, Hugo Van; Lukas, Roman-Patrik

doi:10.1016/j.resuscitation.2010.11.006

Cited by 74 publications

(72 citation statements)

References 24 publications

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“…132 In the largest study (9136 patients) a covariate-adjusted spline analysis showed a maximum survival at a mean depth of 4.0 to 5.5 cm (1.6 to 2.2 inches), with a peak at 4.6 cm (1.8 inches). 135 For the critical outcome of ROSC, we found low-quality evidence (downgraded for imprecision, upgraded for a doseresponse gradient) from 4 observational studies 134,135,137,140 suggesting that a compression depth of more than 5 cm (2 inches) in adults is better than all other compression depths during manual CPR. The largest study reported that ROSC increased with each 5 mm increment (adjusted OR 1.06 [95% CI: 1.04 to 1.08, P<0.001]) and that the adjusted OR for ROSC for patients receiving chest compressions with a depth of 3.8 to 5.1 cm (1.5 to 2 inches) compared with more than 5.1 cm (more than 2 inches) was 0.86 (95% CI, 0.75-0.97).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…This review identified 12 studies, of which 2 studies were randomized studies 133,137 and 10 studies were observational of before-after design. 131,140,143,[159][160][161][162][163][164][165] The included studies were 9 studies in 3716 adults 131 131 had a mixture of patients from in and out-of-hospital settings.…”

Section: Consensus On Sciencementioning

confidence: 99%

“…Feedback devices examined included accelerometer-based devices 133,137,140,143,159,161,[163][164][165] and audiotape of prompts. 131,160,162 Compared with the previous evidence review performed in 2010, this review identified 8 new studies that were included for analysis.…”

Section: Consensus On Sciencementioning

confidence: 99%

“…131,160,162 Compared with the previous evidence review performed in 2010, this review identified 8 new studies that were included for analysis. 133,137,140,143,161,[163][164][165] The nature of using feedback or prompt devices meant that all studies suffered from performance and detection bias because healthcare professionals were not blinded to intervention (feedback or no feedback).…”

Section: Consensus On Sciencementioning

confidence: 99%

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Part 3: Adult Basic Life Support and Automated External Defibrillation

Travers¹,

Perkins²,

Berg³

et al. 2015

Circulation

234

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Introduction This Part of the 2015 International Consensus on Cardiopul monary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations (CoSTR) presents the consensus on science and treatment recommendations for adult basic life support (BLS) and automated external defibrillation (AED). After the publication of the 2010 CoSTR, the Adult BLS Task Force developed review questions in PICO (population, intervention, comparator, outcome) format.1 This resulted in the generation of 36 PICO questions for systematic reviews. The task force discussed the topics and then voted to prioritize the most important questions to be tackled in 2015. From the pool of 36 questions, 14 were rated low priority and were deferred from this round of evidence evaluation. Two new questions were submitted by task force members, and 1 was submitted via the public portal. Two of these (BLS 856 and BLS 891) were taken forward for evidence review. The third question (368: ForeignBody Airway Obstruction) was deferred after a preliminary review of the evidence failed to identify compelling evidence that would alter the treatment recommendations made when the topic was last reviewed in 2005. 2 Each task force performed a systematic review using detailed inclusion and exclusion criteria, based on the recommendations of the Institute of Medicine of the National Academies.3 With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).Reviewers were unable to identify any relevant evidence for 3 questions (BLS 811, BLS 373, and BLS 348), and the evidence review was not completed in time for a further question (BLS 370). A revised PICO question was developed for the opioid question (BLS 891). The task force reviewed 23 PICO questions for the 2015 consensus on science and treatment recommendations, including BLS 811, BLS 373, and BLS 348. The PICO flow is summarized in Figure 1.Using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group, 4 the reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 5 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 6 and GRADE for observational studies that inform both therapy and prognosis questions.7 GRADE evidence profile tables 8 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. Critical outcomes were defined as neurologically favorable outcome (level 9), survival (level 8), and return of spontaneous circulation (ROSC; level 7). Given the heterogeneity of time points evaluated in the studies related to BLS/AED, time intervals were pooled across outcomes. For neurologic outcome and survival, we considered the outcomes at discharge,...

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Section: Consensus On Sciencementioning

confidence: 99%

Section: Consensus On Sciencementioning

confidence: 99%

Section: Consensus On Sciencementioning

confidence: 99%

Section: Consensus On Sciencementioning

confidence: 99%

See 2 more Smart Citations

Part 3: Adult Basic Life Support and Automated External Defibrillation

Travers¹,

Perkins²,

Berg³

et al. 2015

Circulation

234

View full text Add to dashboard Cite

show abstract

“…improved with the use of real-time CPR feedback, a causal relationship between CPR feedback and survival could not be established. Of the studies included in the systematic review, only one randomized trial was powered to detect neurologically intact survival to discharge, 27 while one study reported observational evidence suggesting improved outcomes with real-time CPR feedback. 28 The highlighted research would seem to suggest that CPR feedback may not be sufficient in and of itself to overcome system (EMS response time, bystander CPR, bystander witnessed status, public v. private location of arrest) and patient characteristics (i.e., presenting rhythm, age gender) in determining patient survival.…”

Section: Cpr Feedbackmentioning

confidence: 99%

The impact of prehospital resuscitation research on in-hospital care

Mausz

Cheskes

2015

CJEM

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Since their introduction over 40 years ago, paramedics have been trained to deliver select advanced life support interventions in the community with the goal of reducing morbidity and mortality from cardiovascular disease and trauma. The ensuing decades witnessed a great deal of interest in paramedic care, with an exponential growth in prehospital resuscitation research. As part of the CJEM series on emergency medical services (EMS), we review recent prehospital research in out-of-hospital cardiac arrest and discuss how, in a novel departure from the origins of EMS, prehospital research is beginning to influence in-hospital care. We discuss emerging areas of study related to cardiopulmonary resuscitation (CPR) quality, therapeutic hypothermia, termination of resuscitation, and the use of end-tidal carbon dioxide measurement, as well as the subtle ripple effects that prehospital research is having on the broader understanding of the management of these critically ill patients. RÉSUMÉDepuis leur arrivée il y a plus d'une quarantaine d'années, les ambulanciers paramédicaux sont formés pour pratiquer certaines interventions de réanimation cardiorespiratoire (RCR) médicalisée dans la collectivité dans le but de réduire la morbidité et la mortalité liées aux maladies cardiovasculaires et aux traumas. Au cours des décennies suivantes, les soins paramédicaux ont suscité un vif intérêt, qui s'est accompagné d'une forte croissance de la recherche en réanimation préhospitalière. Dans le cadre de la série d'articles portant sur les services médi-caux d'urgence (SMU) dans le JCMU, il sera question de la recherche récente sur la prise en charge préhospitalière des arrêts cardiaques qui surviennent dans la collectivité ainsi que de l'influence que commence à avoir la recherche dans le domaine préhospitalier sur les soins hospitaliers, influence qui signe une nouvelle orientation par rapport au point de départ des SMU. L'article portera sur de nouveaux champs d'étude liés à la qualité de la RCR, à l'hypothermie thérapeutique, à l'arrêt des manoeuvres de réanimation et à l'utilisation de la mesure du gaz carbonique en fin d'expiration ainsi que sur les effets d'entraînement discrets que la recherche dans le domaine préhospitalier a sur la compréhension élargie du traitement des personnes gravement malades ou blessées.

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Effective deployment of public‐access automated external defibrillators to improve out‐of‐hospital cardiac arrest outcomes

Nakahara

Sakamoto

2017

J of Gen and Family Med

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Out‐of‐hospital cardiac arrest (OHCA) is a major health concern in Japan and other developed countries with aging populations. Improvements in OHCA outcomes require streamlining the chain of survival. Deployment of public‐access automated external defibrillators (PADs) and defibrillation by bystanders is one strategy that may streamline the chain by reducing the time to defibrillation in individuals with shockable rhythms. Although the effectiveness of PAD programs in increasing survival to discharge has been reported, there have been criticisms and concerns about the small population impact, cost‐effectiveness, and potential negative impact on those with nonshockable rhythms. This article reviews relevant literature regarding the effectiveness and concerns regarding PAD for OHCA.

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The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest – A prospective, randomized trial

Cited by 74 publications

References 24 publications

Part 3: Adult Basic Life Support and Automated External Defibrillation

Part 3: Adult Basic Life Support and Automated External Defibrillation

The impact of prehospital resuscitation research on in-hospital care

Effective deployment of public‐access automated external defibrillators to improve out‐of‐hospital cardiac arrest outcomes

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