CPR Feedback Device and Training Improves CPR Quality in Pediatric Patients | Journal Scan
Does “just-in-time” (JIT) cardiopulmonary resuscitation (CPR) training with visual feedback or real-time visual feedback during cardiopulmonary arrest (CPA) improve quality of chest compressions during simulated CPA?
A prospective, randomized, 2 x 2 factorial designed trial was performed at 10 international centers. Each three-person team was randomized to one of four permutations. The control group viewed a standardized video and underwent 2 minutes of CPR practice. The intervention groups included: 1) No JIT CPR visual feedback training before CPA and real-time visual feedback during CPA, 2) JIT CPR visual feedback training before CPA and no real-time visual feedback training during CPA, and 3) JIT CPR visual feedback training before CPA and real-time visual feedback training during CPA. The visual feedback device provided feedback using light-emitting diodes for chest compression depth and rate. All teams participated in a standardized 12-minute pediatric CPA scenario. Outcome measures included achievement of American Heart Association recommendations of chest compression rate of 100-120 per minute and chest compression depth exceeding 50 mm.
A total of 324 providers were assigned to three-person resuscitation teams (total of 108 teams). Mean depth and rate compliance were 12.7% and 27.1%, respectively, in the control group. JIT training improved depth compliance by 19.9% (p < 0.001) and rate compliance by 12% (p = 0.037). Visual feedback compared with no visual feedback improved depth compliance by 15.4% (p = 0.001) and rate compliance by 40.1% (p < 0.001). Combining both interventions showed the highest compliance, but was not statistically superior to either intervention alone. CC fraction (percentage of CPR time during arrest) was excellent (>89%) in all groups.
The authors concluded that CPR quality as performed by health care professionals is poor. JIT training and real-time visual feedback, alone or in combination, improved CPR quality.
Performing high-quality CPR should be considered a fundamental skill for health care professionals. The baseline CPR quality in the study was dismal, and although improved with the study, remained poor, with <50% of chest compressions meeting American Heart Association guidelines for depth after the intervention. Results were somewhat better for chest compression rate, with improvement to nearly 80% with visual feedback. This study supports application of the interventions described, but also needed are systemic efforts at monitoring and improving CPR quality across hospitals and health care systems.
Keywords: Cardiopulmonary Resuscitation, Heart Arrest, Resuscitation, Pediatrics, Feedback, Feedback, Sensory, Outcome Assessment (Health Care), American Heart Association, Prospective Studies, Control Groups
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