Vol 26, No 5 (2019)
Original articles — Clinical cardiology
Published online: 2018-08-24
Does the use of cardiopulmonary resuscitation feedback devices improve the quality of chest compressions performed by doctors? A prospective, randomized, cross-over simulation study
Abstract
Background: The aim of the study was to compare the quality of chest compressions (CCs) carried out with and without the use of the TrueCPR device during simulated cardiopulmonary resuscitations conducted by trainee doctors.
Methods: The study was a prospective, randomized, cross-over simulation study. The study involved 65 trainee doctors who were tasked with performing a 2-min cycle of uninterrupted CCs under conditions of a simulated cardiopulmonary resuscitation of adults. CC were carried out in two scenarios: with and without TrueCPR chest compression support. Participants did not have experience in the use of CCs prior to this study.
Results: The depth of compressions in regard to CC techniques were varied by 45 mm (IQR 43–48) for manual CC and 53 mm (IQR 51–55) for the TrueCPR device (p < 0.001). The incidence of CCs with and without TrueCPR was: 112 (IQR 103–113) vs. 129 (IQR 122–135) compressions (p = 0.002). The degree of complete chest relaxation with the TrueCPR device was 95% (IQR 76–99) and without the device, 33% (IQR 29–38) (p < 0.001).
Conclusions: In the simulation study performed, the use of the TrueCPR device resulted in a significant improvement in the quality of CCs in relation to frequency and depth of CCs and correctness of chest relaxation.
Keywords: cardiopulmonary resuscitationchest compressionsqualitymedical simulationdoctor
References
- Kempa M, Królak T, Drelich Ł, et al. Pre-discharge defibrillation testing: Is it still justified? Cardiol J. 2016; 23(5): 532–538.
- Freund B, Kaplan PW. A review of the utility of a hypothermia protocol in cardiac arrests due to non-shockable rhythms. Cardiol J. 2017; 24(3): 324–333.
- Monsieurs KG, Nolan JP, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015; 95: 1–80.
- Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2): S444–S464.
- Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2): S414–S435.
- Kurowski A, Szarpak Ł, Bogdański Ł, et al. Comparison of the effectiveness of cardiopulmonary resuscitation with standard manual chest compressions and the use of TrueCPR and PocketCPR feedback devices. Kardiol Pol. 2015; 73(10): 924–930.
- Zideman DA, De Buck EDJ, Singletary EM, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. First aid. Resuscitation. 2015; 95: 278–287.
- Ewy GA, Zuercher M, Hilwig RW, et al. Improved neurological outcome with continuous chest compressions compared with 30:2 compressions-to-ventilations cardiopulmonary resuscitation in a realistic swine model of out-of-hospital cardiac arrest. Circulation. 2007; 116(22): 2525–2530.
- Nishiyama C, Iwami T, Kawamura T, et al. Quality of chest compressions during continuous CPR; comparison between chest compression-only CPR and conventional CPR. Resuscitation. 2010; 81(9): 1152–1155.
- Chalkias A, Iacovidou N, Xanthos T. Continuous chest compression pediatric cardiopulmonary resuscitation after witnessed electrocution. Am J Emerg Med. 2014; 32(6): 686.e1–686.e2.
- Neumar RW, Shuster M, Callaway CW, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2): S315–S367.
- Smereka J, Szarpak L, Rodríguez-Núñez A, et al. A randomized comparison of three chest compression techniques and associated hemodynamic effect during infant CPR: A randomized manikin study. Am J Emerg Med. 2017; 35(10): 1420–1425.
- Smereka J, Kasiński M, Smereka A, et al. The quality of a newly developed infant chest compression method applied by paramedics: a randomised crossover manikin trial. Kardiol Pol. 2017; 75(6): 589–595.
- Treptau J, Ebnet J, Akin M, et al. Angiographic detection of fatal acute aortic dissection Stanford type A under resuscitation. Cardiol J. 2016; 23(6): 620–622.
- Kim MJ, Park YS, Kim SW, et al. Chest injury following cardiopulmonary resuscitation: a prospective computed tomography evaluation. Resuscitation. 2013; 84(3): 361–364.
- Kurowski A, Czyżewski L, Bogdański L, et al. Quality of chest compression with CardioPump CPR compared to single rescuer standard BLS. Am J Emerg Med. 2015; 33(1): 114–115.
- Szarpak L, Filipiak KJ, Ładny JR, et al. Should nurses use mechanical chest compression devices during CPR? Am J Emerg Med. 2016; 34(10): 2044–2045.
- Szarpak Ł, Truszewski Z, Smereka J, et al. Does the use of a chest compression system in children improve the effectiveness of chest compressions? A randomised crossover simulation pilot study. Kardiol Pol. 2016; 74(12): 1499–1504.
- Lampe JW, Tai Y, Bratinov G, et al. Developing a kinematic understanding of chest compressions: the impact of depth and release time on blood flow during cardiopulmonary resuscitation. Biomed Eng Online. 2015; 14: 102.
- Iskrzycki L, Smereka J, Rodriguez-Nunez A, et al. The impact of the use of a CPRMeter monitor on quality of chest compressions: a prospective randomised trial, cross-simulation. Kardiol Pol. 2018; 76(3): 574–579.
- Buléon C, Delaunay J, Parienti JJ, et al. Impact of a feedback device on chest compression quality during extended manikin CPR: a randomized crossover study. Am J Emerg Med. 2016; 34(9): 1754–1760.
- Truszewski Z, Szarpak L, Kurowski A, et al. Randomized trial of the chest compressions effectiveness comparing 3 feedback CPR devices and standard basic life support by nurses. Am J Emerg Med. 2016; 34(3): 381–385.
- Abelairas-Gómez C, Barcala-Furelos R, Szarpak Ł, et al. The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation. Kardiol Pol. 2017; 75(1): 21–27.
- Smereka J, Szarpak L, Smereka A, et al. Evaluation of new two-thumb chest compression technique for infant CPR performed by novice physicians. A randomized, crossover, manikin trial. Am J Emerg Med. 2017; 35(4): 604–609.
- Field RA, Soar J, Davies RP, et al. The impact of chest compression rates on quality of chest compressions: a manikin study. Resuscitation. 2012; 83(3): 360–364.
- Lee SH, Kim K, Lee JH, et al. Does the quality of chest compressions deteriorate when the chest compression rate is above 120/min? Emerg Med J. 2014; 31(8): 645–648.
- Zou Y, Shi W, Zhu Y, et al. Rate at 120/min provides qualified chest compression during cardiopulmonary resuscitation. Am J Emerg Med. 2015; 33(4): 535–538.
- Wee JCP, Nandakumar M, Chan YH, et al. Effect of using an audiovisual CPR feedback device on chest compression rate and depth. Ann Acad Med Singapore. 2014; 43(1): 33–38.
- Krasteva V, Jekova I, Didon JP. An audiovisual feedback device for compression depth, rate and complete chest recoil can improve the CPR performance of lay persons during self-training on a manikin. Physiol Meas. 2011; 32(6): 687–699.
- Ruiz de Gauna S, González-Otero DM, Ruiz J, et al. Feedback on the rate and depth of chest compressions during cardiopulmonary resuscitation using only accelerometers. PLoS One. 2016; 11(3): e0150139.
- Wieczorek W, Smereka J, Ladny JR, et al. The impact of a CPRezy™ feedback device on the quality of chest compressions performed by nurses. Am J Emerg Med. 2018; 36(7): 1318–1319.
- Kirkbright S, Finn J, Tohira H, et al. Audiovisual feedback device use by health care professionals during CPR: a systematic review and meta-analysis of randomised and non-randomised trials. Resuscitation. 2014; 85(4): 460–471.
- Lurie K, Voelckel W, Plaisance P, et al. Use of an inspiratory impedance threshold valve during cardiopulmonary resuscitation: a progress report. Resuscitation. 2000; 44(3): 219–230.
- Wieczorek W, Kaminska H. Impact of a corpuls CPR Mechanical Chest Compression Device on chest compression quality during extended pediatric manikin resuscitation: a randomized crossover pilot study. Disaster Emerg Med J. 2017; 2(2): 58–63.
- Beckers SK, Skorning MH, Fries M, et al. CPREzy improves performance of external chest compressions in simulated cardiac arrest. Resuscitation. 2007; 72(1): 100–107.
- Szarpak L, Truszewski Z, Czyzewski L, et al. A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study. Am J Emerg Med. 2016; 34(8): 1338–1341.
- Szarpak Ł, Czyżewski Ł, Kurowski A. Comparison of the Pentax, Truview, GlideScope, and the Miller laryngoscope for child intubation during resuscitation. Am J Emerg Med. 2015; 33(3): 391–395.
- Evrin T, Bielski KT. Is there any difference between different infant chest compression methods? Disaster Emerg Med J. 2017; 2(4): 173–174.
- Frass M, Robak O, Truszewski Z, et al. Comparison of endotracheal intubation with the airtraq avant® and the macintosh laryngoscope during intermittent or continuous chest compression: a randomized, crossover study in manikins. Disaster Emerg Med J. 2016; 1(1): 7–13.
- Aleksandrowicz S, Madziala M, Iskrzycki L, et al. Performance of chest compressions with the use of the new mechanical chest compression machine lifeline arm: a randomized crossover manikin study in novice physicians. Disaster Emerg Med J. 2016; 1(1): 30–36.
