Vol 28, No 3 (2021)
Original Article
Published online: 2019-09-24

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How should we teach cardiopulmonary resuscitation? Randomized multi-center study

Burak Katipoglu1, Marcin Andrzej Madziala2, Togay Evrin1, Pawel Gawlowski3, Agnieszka Szarpak4, Agata Dabrowska5, Szymon Bialka6, Jerzy Robert Ladny7, Lukasz Szarpak2, Anna Konert4, Jacek Smereka3
Pubmed: 31565794
Cardiol J 2021;28(3):439-445.

Abstract

Background: A 2017 update of the resuscitation guideline indicated the use of cardiopulmonary resuscitation (CPR) feedback devices as a resuscitation teaching method. The aim of the study was to compare the influence of two techniques of CPR teaching on the quality of resuscitation performed by medical students.

Methods: The study was designed as a prospective, randomized, simulation study and involved 115 first year students of medicine. The participants underwent a basic life support (BLS) course based on the American Heart Association guidelines, with the first group (experimental group) performing chest compressions to observe, in real-time, chest compression parameters indicated by software included in the simulator, and the second group (control group) performing compressions without this possibility. After a 10-minute resuscitation, the participants had a 30-minute break and then a 2-minute cycle of CPR. One month after the training, study participants performed CPR, without the possibility of observing real-time measurements regarding quality of chest compression.

Results: One month after the training, depth of chest compressions in the experimental and control group was 50 mm (IQR 46–54) vs. 39 mm (IQR 35–42; p = 0.001), compression rate 116 CPM (IQR 102–125) vs. 124 CPM (IQR 116–134; p = 0.034), chest relaxation 86% (IQR 68–89) vs. 74% (IQR 47–80; p = 0.031) respectively.

Conclusions: Observing real-time chest compression quality parameters during BLS training may improve the quality of chest compression one month after the training including correct hand positioning, compressions depth and rate compliance.

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References

  1. Gräsner JT, Bossaert L. Epidemiology and management of cardiac arrest: what registries are revealing. Best Pract Res Clin Anaesthesiol. 2013; 27(3): 293–306.
  2. Berdowski J, Berg RA, Tijssen JGP, et al. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010; 81(11): 1479–1487.
  3. Jagosz A, Bursy D, Sobon A, et al. In-hospital sudden cardiac arrest protocol analysis. Kardiol Pol. 2018; 76(2): 376–380.
  4. Vaillancourt C, Verma A, Trickett J, et al. Evaluating the effectiveness of dispatch-assisted cardiopulmonary resuscitation instructions. Acad Emerg Med. 2007; 14(10): 877–883.
  5. 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.
  6. Smereka J, Madziala M, Szarpak L. Comparison of two infant chest compression techniques during simulated newborn cardiopulmonary resuscitation performed by a single rescuer: A randomized, crossover multicenter trial. Cardiol J. 2018 [Epub ahead of print].
  7. 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.
  8. Smereka J, Iskrzycki Ł, Makomaska-Szaroszyk E, et al. The effect of chest compression frequency on the quality of resuscitation by lifeguards. A prospective randomized crossover multicenter simulation trial. Cardiol J. 2018 [Epub ahead of print].
  9. Czekjalo M. Are we prepared to use bag-mask-ventilation during continuous chest compression? Disaster and Emergency Medicine Journal. 2018; 3(4): 148–149.
  10. Majer J, Madziala A, Dabrowska A, et al. The place of TrueCPR feedback device in cardiopulmonary resuscitation. Should we use it? A randomized pilot study. Disaster and Emergency Medicine Journal. 2018; 3(4): 131–136.
  11. Jorge-Soto C, Abilleira-González M, Otero-Agra M, et al. Schoolteachers as candidates to be basic life support trainers: A simulation trial. Cardiol J. 2018 [Epub ahead of print].
  12. Wieczorek W, Smereka J, Szarpak L, et al. Which position for resuscitation should we take? A randomized crossover manikin study. Am J Emerg Med. 2018; 36(5): 899–900.
  13. 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.
  14. Szarpak L, Truszewski Z, Czyzewski L, et al. CPR using the lifeline ARM mechanical chest compression device: a randomized, crossover, manikin trial. Am J Emerg Med. 2017; 35(1): 96–100.
  15. Kleinman ME, Goldberger ZD, Rea T, et al. 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2018; 137(1): e7–ee13.
  16. 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.
  17. 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.
  18. Oh JeH, Kim CW. The use of the PocketCPR application in basic life support training. Am J Emerg Med. 2017; 35(1): 189–190.
  19. 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.
  20. Monsieurs KG, Nolan JP, Bossaert LL, et al. ERC Guidelines 2015 Writing Group. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015; 95: 1–80.
  21. 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.
  22. Majer J, Kaminska H, Wieczorek W, et al. IMPACT OF A CPRMETER FEEDBACK DEVICE ON CHEST COMPRESSION QUALITY PERFORMED BY NURSES — A RANDOMIZED CROSSOVER STUDY. Disaster and Emergency Medicine Journal. 2018; 3(1): 36–37.
  23. 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.
  24. 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.
  25. Jäntti H, Silfvast T, Turpeinen A, et al. Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins. Resuscitation. 2009; 80(4): 453–457.
  26. 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.
  27. 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.
  28. Solevåg AL, Schmölzer GM. Optimal Chest Compression Rate and Compression to Ventilation Ratio in Delivery Room Resuscitation: Evidence from Newborn Piglets and Neonatal Manikins. Front Pediatr. 2017; 5: 3.
  29. 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.
  30. Lee SH, Ryu JiHo, Min MKi, et al. Optimal chest compression rate in cardiopulmonary resuscitation: a prospective, randomized crossover study using a manikin model. Eur J Emerg Med. 2016; 23(4): 253–257.
  31. Idris AH, Guffey D, Aufderheide TP, et al. Resuscitation Outcomes Consortium (ROC) Investigators. Relationship between chest compression rates and outcomes from cardiac arrest. Circulation. 2012; 125(24): 3004–3012.
  32. Dosman CF, Jones RL. High-frequency chest compression: a summary of the literature. Can Respir J. 2005; 12(1): 37–41.
  33. Austin AL, Spalding CN, Landa KN, et al. A Randomized Control Trial of Cardiopulmonary Feedback Devices and Their Impact on Infant Chest Compression Quality: A Simulation Study. Pediatr Emerg Care. 2017 [Epub ahead of print].
  34. 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.