Usefulness of a metronome to improve quality of chest compressions during cardiopulmonary resuscitation

Khorasani-Zadeh, Arshia; Krowl, Lauren; Chowdhry, Amit K.; Hantzidiamantis, Paris J.; Hantzidiamantis, Konstantino; Siciliano, Rosalie; Grover, Matthew A; Dhamoon, Amit S.

doi:10.1080/08998280.2020.1805840

Cited by 5 publications

(17 citation statements)

References 11 publications

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“…As CPR quality was not measured, the exact mechanism for the large difference in survival in unclear [36 ▪ ]. The two most recent observational studies report improved CPR quality with real-time audio-visual feedback [37] and a simple metronome [38], and the clinical usefulness of these devices continue to be debated.…”

Section: Improving Resuscitation Qualitymentioning

confidence: 99%

Basic life support and systems saving lives

Olasveengen

Semeraro²

2021

Current Opinion in Critical Care

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Purpose of reviewTo describe recent science in basic life support (BLS) after cardiac arrest and how evolving knowledge in resuscitation is changing current guidelines and practices. Recent findingsThe core elements of BLS have remained mostly unchanged since 2005 when Cardiopulmonary Resuscitation recommendations were changed from 2 ventilations to 15 compressions and up to three stacked shocks for shockable rhythms, to 30 compressions to 2 ventilations and single shocks. Since 2010, basic life support has largely focused on the importance of providing high-quality CPR for professional and lay rescuers alike. The most recent resuscitation updates has seen an increased focus on the systems perspective. The 'Systems Saving Lives' concept emphasizes the interconnection between community and Emergency Medical Services (EMS). The main changes in current resuscitation practice are within three important basic life support domains: recognition of cardiac arrest, interaction between rescuers and EMS and improving resuscitation quality.

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Section: Improving Resuscitation Qualitymentioning

confidence: 99%

Basic life support and systems saving lives

Olasveengen

Semeraro²

2021

Current Opinion in Critical Care

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“…This enabled HCPs to focus more on clinical decision making and patient status, which was associated with better overall patient care. Cognitive aids used during IHCAs may include timers, metronomes, algorithm cards, and smartphone applications 1,11–14 …”

Section: Introductionmentioning

confidence: 99%

The impact of a smartphone‐based cognitive aid on clinical performance during cardiac arrest simulations: A randomized controlled trial

Brophy

McCue

Reel

et al. 2023

AEM Education and Training

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Objectives In‐hospital cardiac arrests are common and associated with high mortality. Smartphone applications offer quick access to algorithms and timers but often lack real‐time guidance. This study assesses the impact of the Code Blue Leader application on the performance of providers leading cardiac arrest simulations. Methods This open‐label randomized controlled trial included Advanced Cardiac Life Support (ACLS)–trained medical doctors (MD) and registered nurses (RN). Participants were randomized to lead the same ACLS simulation with or without the app. The primary outcome, “performance score,” was assessed by a trained rater using a validated ACLS scoring system. Secondary outcomes included percentage of critical actions performed, number of incorrect actions, and chest compression fraction (percentage of time spent performing chest compressions). A sample size of 30 participants was calculated to detect a difference of 20% at the 0.05 alpha level with 90% power. Results Fifteen MDs and 15 RNs underwent stratified randomization. The median (interquartile range) performance score in the app group was 95.3% (93.0%–100.0%) compared to 81.4% (60.5%–88.4%) in the control group, demonstrating an effect size of r = 0.69 (Z = −3.78, r = 0.69, p = 0.0002). The percentage of critical actions performed in the app group was 100% (96.2%–100.0%) compared to 85.0% (74.1%–92.4%) in the control group. The number of incorrect actions performed in the app group was 1 (1) compared to 4 (3–5) in the control group. Chest compression fraction in the app group was 75.5% (73.0%–84.0%) compared to 75.0% (72.0%–85.0%) in the control group. Conclusions The Code Blue Leader smartphone app significantly improved the performance of ACLS‐trained providers in cardiac arrest simulations.

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“…A clinical observational study of human cardiac arrest patients reported a compression rate compliance of only 28%. 9 A study assessing the ability of veterinary students without prior CPR experience to deliver a compression rate of 100 cpm on a canine manikin found that 53% of participants were successful. 10 A clinical study by Hoehne et al documented a compression rate compliance of 76% in a prospective study involving 219 CPR events.…”

Section: Introductionmentioning

confidence: 99%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

“…8,12,15 A traditional metronome is a low-cost and readily available device, which may be used as an auditory aid. 9,14,16,18,21 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.…”

Section: Introductionmentioning

confidence: 99%

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

Genetti,

Llewellyn

2023

J Vet Emergen Crit Care

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ObjectiveTo assess compression rate accuracy among veterinarians and registered veterinary nurses (RVNs) without and with an audible aid.DesignProspective study with use of a canine CPR manikin.SettingSmall animal teaching hospital.SubjectsThirty‐six participants (20 veterinarians and 16 RVNs).InterventionsEach participant completed the first 2‐minute cycle of chest compressions without an auditory aid on a canine CPR manikin. Each participant was then randomized to 1 of 3 auditory aid groups (Group B: Bee Gees “Stayin’ Alive”; Group Q: Queen “Another One Bites the Dust”; or Group M: traditional metronome) and then completed a second 2‐minute cycle of chest compressions with the instruction to synchronize their compression rate with the beat of the auditory aid. An accurate chest compression rate was defined as obtaining a rate between 100 and 120 compressions per minute (cpm).Measurements and Main ResultsMedian number of compressions administered by participants during Cycle 1 for the first minute was 111 (range 88–140) and for the second minute was 107 (range 80–151), with 25 of 36 (69%) participants obtaining an accurate chest compression rate. Median number of compressions administered during Cycle 2 for the first minute was 110 (range 76–125) and for the second minute was 110 (range 72–125), with 34 of 36 participants (94%) obtaining an accurate chest compression rate. Participants were more likely to obtain an accurate chest compression rate when an auditory aid was present compared to without (McNemar's test; P = 0.013). Subgroup analysis suggested the auditory aid was beneficial in Groups Q and M but not Group B (Kruskal–Wallis with Dunn's post hoc testing; P = 0.014, P = 0.0455, and P = 0.5637, respectively).ConclusionsAn auditory aid was associated with improved chest compression rate accuracy. However, as the auditory aid was not beneficial for Group B participants, our findings suggest that some auditory aids are more helpful than others.

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Usefulness of a metronome to improve quality of chest compressions during cardiopulmonary resuscitation

Cited by 5 publications

References 11 publications

Basic life support and systems saving lives

Basic life support and systems saving lives

The impact of a smartphone‐based cognitive aid on clinical performance during cardiac arrest simulations: A randomized controlled trial

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

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