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Kahsay DT, Peltonen LM, Rosio R, Tommila M, Salanterä S. The effect of standalone audio-visual feedback devices on the quality of chest compressions during laypersons' cardiopulmonary resuscitation training: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2024; 23:11-20. [PMID: 37154435 DOI: 10.1093/eurjcn/zvad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023]
Abstract
AIMS Individual studies that investigated the effect of standalone audio-visual feedback (AVF) devices during laypersons' cardiopulmonary resuscitation (CPR) training have yielded conflicting results. This review aimed to evaluate the effect of standalone AVF devices on the quality of chest compressions during laypersons' CPR training. METHOD AND RESULT Randomized controlled trials of simulation studies recruiting participants without actual patient CPR experience were included. The intervention evaluated was the quality of chest compressions with standalone AVF devices vs. without AVF devices. Databases, such as PubMed, Cochrane Central, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and PsycINFO, were searched from January 2010 to January 2022. The risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis alongside a narrative synthesis was used for examining the effect of standalone AVF devices.Sixteen studies were selected for this systematic review. A meta-analysis revealed an increased compression depth of 2.22 mm [95% CI (Confidence Interval), 0.88-3.55, P = 0.001] when participants performed CPR using the feedback devices. Besides, AVF devices enabled laypersons to deliver compression rates closer to the recommended range of 100-120 per min. No improvement was noted in chest recoil and hand positioning when participants used standalone AVF devices. CONCLUSION The quality of the included studies was variable, and different standalone AVF devices were used. Standalone AVF devices were instrumental in guiding laypersons to deliver deeper compressions without compromising the quality of compression rates. However, the devices did not improve the quality of chest recoil and placement of the hands. REGISTRATION PROSPERO: CRD42020205754.
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Affiliation(s)
- Desale Tewelde Kahsay
- Department of Anaesthesiology and Intensive Care, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
| | | | - Riitta Rosio
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Miretta Tommila
- Department of Anaesthesiology and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
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Lauridsen KG, Løfgren B, Brogaard L, Paltved C, Hvidman L, Krogh K. Cardiopulmonary Resuscitation Training for Healthcare Professionals: A Scoping Review. Simul Healthc 2022; 17:170-182. [PMID: 34652328 DOI: 10.1097/sih.0000000000000608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY STATEMENT The optimal strategy for training cardiopulmonary resuscitation (CPR) for healthcare professionals remains to be determined. This scoping review aimed to describe the emerging evidence for CPR training for healthcare professionals.We screened 7605 abstracts and included 110 studies in this scoping review on CPR training for healthcare professionals. We assessed the included articles for evidence for the following topics: training duration, retraining intervals, e-learning, virtual reality/augmented reality/gamified learning, instructor-learner ratio, equipment and manikins, other aspects of contextual learning content, feedback devices, and feedback/debriefing. We found emerging evidence supporting the use of low-dose, high-frequency training with e-learning to achieve knowledge, feedback devices to perform high-quality chest compressions, and in situ team simulations with debriefings to improve the performance of provider teams.
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Affiliation(s)
- Kasper Glerup Lauridsen
- From the Department of Medicine (K.G.L., B.L.), Randers Regional Hospital, Randers; Research Center for Emergency Medicine (K.G.L., B.L., K.K.), Aarhus University Hospital, Aarhus, Denmark; Center for Simulation, Innovation, and Advanced Education (K.G.L.), Children's Hospital of Philadelphia, Philadelphia; Department of Clinical Medicine (B.L.), Aarhus University; Department of Obstetrics and Gynaecology (L.B., L.H.), Aarhus University Hospital; Corporate HR Midtsim (C.P.) Central Denmark Region; and Department of Anesthesiology, Aarhus University Hospital (K.K.), Aarhus University Hospital, Aarhus, Denmark
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Çalışkan D, Bildik F, Aslaner MA, Kılıçaslan İ, Keleş A, Demircan A. Effects of metronome use on cardiopulmonary resuscitation quality. Turk J Emerg Med 2021; 21:51-55. [PMID: 33969239 PMCID: PMC8092000 DOI: 10.4103/2452-2473.309137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/29/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
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.
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Affiliation(s)
- Dikmen Çalışkan
- Emergency Service, Antalya Kepez State Hospital, Antalya, Turkey
| | - Fikret Bildik
- Department of Emergency, Gazi University School of Medicine, Ankara, Turkey
| | - Mehmet Ali Aslaner
- Department of Emergency, Gazi University School of Medicine, Ankara, Turkey
| | - İsa Kılıçaslan
- Department of Emergency, Gazi University School of Medicine, Ankara, Turkey
| | - Ayfer Keleş
- Department of Emergency, Gazi University School of Medicine, Ankara, Turkey
| | - Ahmet Demircan
- Department of Emergency, Gazi University School of Medicine, Ankara, Turkey
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Hsu SC, Kuo CW, Weng YM, Lin CC, Chen JC. The effectiveness of teaching chest compression first in a standardized public cardiopulmonary resuscitation training program. Medicine (Baltimore) 2019; 98:e14418. [PMID: 30921176 PMCID: PMC6456000 DOI: 10.1097/md.0000000000014418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Effectiveness of bystander cardiopulmonary resuscitation (CPR) is known to provide emergency medical services which reduce the number of deaths in patients with out-of-hospital cardiac arrest. The survival at these patients is affected by the training level of the bystander, but the best format of CPR training is unclear. In this pilot study, we aimed to examine whether the sequence of CPR instruction improves learning retention on the course materials.A total of 95 participants were recruited and divided into 2 groups; Group 1: 49 participants were taught firstly how to recognize a cardiac arrest and activate the emergency response system, and Group 2: 46 participants were taught chest compression first. The performance of participants was observed and evaluated, the results from 1 pre-test and 2 post-tests between 2 groups were then compared.There was a significantly better improvement of participants in Group 2 regarding the recognition of a cardiac arrest and the activation of the emergency response system than of those in Group 1. At the post-test, participants in Group 2 had an improvement in chest compression compared to those in Group 1, but the difference was not statistically significant.Our study had revealed that teaching CPR first in a standardized public education program had improved the ability of participants to recognize cardiac arrest and to activate the emergency response system.
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Affiliation(s)
- Shou-Chien Hsu
- Department of Emergency Medicine, Camillians Saint Mary's Hospital Luodong
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linko
| | - Chan-Wei Kuo
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linko
- Department of Emergency Medicine, Tao-Yuan General Hospital
| | - Yi-Ming Weng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine
- Department of Emergency Medicine, Prehospital Care Division, Tao-Yuan General Hospital
- Faculty of Medicine, National Yang-Ming University
| | - Chi-Chun Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linko
- Department of Emergency Medicine, Ton-Yen General Hospital, Taiwan
| | - Jih-Chang Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linko
- Department of Emergency Medicine, Tao-Yuan General Hospital
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Smereka J, Iskrzycki Ł, Makomaska-Szaroszyk E, Bielski K, Frass M, Robak O, Ruetzler K, Czekajło M, Rodríguez-Núnez A, López-Herce J, Szarpak Ł. The effect of chest compression frequency on the quality of resuscitation by lifeguards. A prospective randomized crossover multicenter simulation trial. Cardiol J 2018; 26:769-776. [PMID: 30338845 DOI: 10.5603/cj.a2018.0121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/16/2018] [Accepted: 10/12/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The ability to perform high-quality cardiopulmonary resuscitation is one of the basic skills for lifeguards. The aim of the study was to assess the influence of chest compression frequency on the quality of the parameters of chest compressions performed by lifeguards. METHODS This prospective observational, randomized, crossover simulation study was performed with 40 lifeguards working in Warsaw, Wroclaw, and Poznan, Poland. The subjects then participated in a target study, in which they were asked to perform 2-min cycles of metronome-guided chest compressions at different rates: 80, 90, 100, 110, 120, 130, 140, and 150 compressions per minute (CPM). RESULTS The study involved 40 lifeguards. Optimal chest compression score calculated by manikin software was achieved for 110-120 CPM. Chest compression depth achieved 53 (interquartile range [IQR] 52-54) mm, 56 (IQR 54-57) mm, 52.5 (IQR 50-54) mm, 53 (IQR 52-53) mm, 50 (IQR 49-51) mm, 47 (IQR 44-51) mm, 41 (IQR 40-42) mm, 38 (IQR 38-43) mm for 80, 90, 100, 110, 120, 130, 140 and 150 CPM, respectively. The percentage of chest compressions with the correct depth was lower for rates exceeding 120 CPM. CONCLUSIONS The rate of 100-120 CPM, as recommended by international guidelines, is the optimal chest compression rate for cardiopulmonary resuscitation performed by lifeguards. A rate above 120 CPM was associated with a dramatic decrease in chest compression depth and overall chest compression quality. The role of full chest recoil should be emphasized in basic life support training.
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Affiliation(s)
- Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland., Wroclaw, Poland
| | - Łukasz Iskrzycki
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland., Wroclaw, Poland
| | | | | | - Michael Frass
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oliver Robak
- Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Kurt Ruetzler
- Departments of Outcomes Research and General Anesthesia, Cleveland Clinic, Cleveland, OH, USA., Cleveland, United States
| | - Michael Czekajło
- Hounter Holmes McGuire Center for Simulation and Healthcare, Virginia Commonwealth University, Richmond, VA, USA, Richmond, United States
| | - Antonio Rodríguez-Núnez
- Paediatric Emergency and Critical Care Division, Paediatric Area Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Santiago de Compostela, Spain
| | - Jesús López-Herce
- Paediatric Intensive Care Department, Hospital General Universitario Gregorio Marannón, Medical School, Complutense University of Madrid, Madrid, Spain., Madrid, Spain
| | - Łukasz Szarpak
- Lazarski University, Warsaw, Poland. .,Hounter Holmes McGuire Center for Simulation and Healthcare, Virginia Commonwealth University, Richmond, VA, USA, Richmond, United States.
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Can a Software-Based Metronome Tool Enhance Compression Rate in a Realistic 911 Call Scenario Without Adversely Impacting Compression Depth for Dispatcher-Assisted CPR? Prehosp Disaster Med 2018; 33:399-405. [PMID: 30033904 DOI: 10.1017/s1049023x18000602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
IntroductionImplementation of high-quality, dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is critical to improving survival from out-of-hospital cardiac arrest (OHCA). However, despite some studies demonstrating the use of a metronome in a stand-alone setting, no research has yet demonstrated the effectiveness of a metronome tool in improving DA-CPR in the context of a realistic 911 call or using instructions that have been tested in real-world emergency calls.HypothesisUse of the metronome tool will increase the proportion of callers able to perform CPR within the target rate without affecting depth. METHODS The prospective, randomized, controlled study involved simulated 911 cardiac arrest calls made by layperson-callers and handled by certified emergency medical dispatchers (EMDs) at four locations in Salt Lake City, Utah USA. Participants were randomized into two groups. In the experimental group, layperson-callers received CPR pre-arrival instructions with metronome assistance. In the control group, layperson-callers received only pre-arrival instructions. The primary outcome measures were correct compression rate (counts per minute [cpm]) and depth (mm). RESULTS A total of 148 layperson-callers (57.4% assigned to experimental group) participated in the study. There was a statistically significant association between the number of participants who achieved the target compression rate and experimental study group (P=.003), and the experimental group had a significantly higher median compression rate than the control group (100 cpm and 89 cpm, respectively; P=.013). Overall, there was no significant correlation between compression rate and depth. CONCLUSION An automated software metronome tool is effective in getting layperson-callers to achieve the target compression rate and compression depth in a realistic DA-CPR scenario.Scott G, Barron T, Gardett I, Broadbent M, Downs H, Devey L, Hinterman EJ, Clawson J, Olola C. Can a software-based metronome tool enhance compression rate in a realistic 911 call scenario without adversely impacting compression depth for dispatcher-assisted CPR? Prehosp Disaster Med. 2018;33(4):399-405.
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Yamanaka S, Huh JY, Nishiyama K, Hayashi H. The optimal number of personnel for good quality of chest compressions: A prospective randomized parallel manikin trial. PLoS One 2017; 12:e0189412. [PMID: 29267300 PMCID: PMC5739419 DOI: 10.1371/journal.pone.0189412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 11/25/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Long durational chest compression (CC) deteriorates cardiopulmonary resuscitation (CPR) quality. The appropriate number of CC personnel for minimizing rescuer's fatigue is mostly unknown. OBJECTIVE We determined the optimal number of personnel needed for 30-min CPR in a rescue-team. METHODS We conducted a randomized, manikin trial on healthcare providers. We divided them into Groups A to D according to the assigned different rest period to each group between the 2 min CCs. Groups A, B, C, and D performed CCs at 2, 4, 6, and 8 min rest period. All participants performed CCs for 30 min with a different rest period; participants allocated to Groups A, B, C, and D performed, eight, five, four, and three cycles, respectively. We compared a quality change of CCs among these groups to investigate how the assigned rest period affects the maintenance of CC quality during the 30-min CPR. RESULTS This study involved 143 participants (male 58 [41%]; mean age, 24 years,) for the evaluation. As participants had less rest periods, the quality of their CCs such as sufficient depth ratio declined over 30-min CPR. A significant decrease in the sufficient CC depth ratio was observed in the second to the last cycle as compared to the first cycle. (median changes; A: -4%, B: -3%, C: 0%, and D: 0% p < 0.01). CONCLUSIONS A 6 min rest period after 2 min CC is vital in order to sustain the quality of CC during a 30-min CPR cycle. At least four personnel may be needed to reduce rescuer's fatigue for a 30-min CPR cycle when the team consists of men and women.
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Affiliation(s)
- Syunsuke Yamanaka
- Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan
| | - Ji Young Huh
- Department of Family Medicine, Adventist Medical Center, Okinawa, Japan
| | - Kei Nishiyama
- Department of Trauma and Critical Care Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Hiroyuki Hayashi
- Department of Family Medicine, Family Medicine, University of Fukui Hospital, Fukui, Japan
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