Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | |
Effect of feedback on delaying deterioration in quality of compressions during 2 minutes of continuous chest compressions: a randomized manikin study investigating performance with and without feedback | |
Anne Lippert1  Theis Aagaard1  Nille Birk Wulff1  Peter Buhl Hjortrup1  Tobias Stenbjerg Lyngeraa1  | |
[1] Danish Institute for Medical Simulation, Copenhagen University Hospital, Herlev Hospital, Copenhagen, Denmark | |
关键词: Resuscitation; Cardiac arrest; Advanced life support (ALS); Basic life support (BLS); Cardiopulmonary resuscitation (CPR); | |
Others : 826761 DOI : 10.1186/1757-7241-20-16 |
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received in 2011-11-03, accepted in 2012-02-28, 发布年份 2012 | |
【 摘 要 】
Background
Good quality basic life support (BLS) improves outcome following cardiac arrest. As BLS performance deteriorates over time we performed a parallel group, superiority study to investigate the effect of feedback on quality of chest compression with the hypothesis that feedback delays deterioration of quality of compressions.
Methods
Participants attending a national one-day conference on cardiac arrest and CPR in Denmark were randomized to perform single-rescuer BLS with (n = 26) or without verbal and visual feedback (n = 28) on a manikin using a ZOLL AED plus. Data were analyzed using Rescuenet Code Review. Blinding of participants was not possible, but allocation concealment was performed. Primary outcome was the proportion of delivered compressions within target depth compared over a 2-minute period within the groups and between the groups. Secondary outcome was the proportion of delivered compressions within target rate compared over a 2-minute period within the groups and between the groups. Performance variables for 30-second intervals were analyzed and compared.
Results
24 (92%) and 23 (82%) had CPR experience in the group with and without feedback respectively. 14 (54%) were CPR instructors in the feedback group and 18 (64%) in the group without feedback. Data from 26 and 28 participants were analyzed respectively. Although median values for proportion of delivered compressions within target depth were higher in the feedback group (0-30 s: 54.0%; 30-60 s: 88.0%; 60-90 s: 72.6%; 90-120 s: 87.0%), no significant difference was found when compared to without feedback (0-30 s: 19.6%; 30-60 s: 33.1%; 60-90 s: 44.5%; 90-120 s: 32.7%) and no significant deteriorations over time were found within the groups. In the feedback group a significant improvement was found in the proportion of delivered compressions below target depth when the subsequent intervals were compared to the first 30 seconds (0-30 s: 3.9%; 30-60 s: 0.0%; 60-90 s: 0.0%; 90-120 s: 0.0%). Significant differences were not found in secondary outcome and in other performance variables between the groups and over time
Conclusions
Quality of CPR was maintained during 2 minutes of continuous compressions regardless of feedback in a group of trained rescuers.
【 授权许可】
2012 Lyngeraa et al; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20140713102919754.pdf | 262KB | download | |
Figure 1. | 57KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Edelson DP, Abella BS, Kramer-Johansen J, Wik L, Myklebust H, Barry AM, et al.: Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resusc 2006, 71:137-145.
- [2]Koster RW, Baubin MA, Bossaert LL, Caballero A, Cassan P, Castren M, et al.: European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators. Resusc 2010, 81:1277-1292.
- [3]Kramer-Johansen J, Myklebust H, Wik L, Fellows B, Svensson L, Sorebo H, et al.: Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resusc 2006, 71:283-292.
- [4]Boyle AJ, Wilson AM, Connelly K, McGuigan L, Wilson J, Whitbourn R: Improvement in timing and effectiveness of external cardiac compressions with a new non-invasive device: the CPR-Ezy. Resusc 2002, 54:63-67.
- [5]Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, et al.: European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resusc 2010, 81:1305-1352.
- [6]Ashton A, McCluskey A, Gwinnutt CL, Keenan AM: Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resusc 2002, 55:151-155.
- [7]Ochoa FJ, Ramalle-Gomara E, Lisa V, Saralegui I: The effect of rescuer fatigue on the quality of chest compressions. Resusc 1998, 37:149-152.
- [8]Bjorshol CA, Soreide E, Torsteinbo TH, Lexow K, Nilsen OB, Sunde K: Quality of chest compressions during 10 min of single-rescuer basic life support with different compression: ventilation ratios in a manikin model. Resusc 2008, 77:95-100.
- [9]Sugerman NT, Edelson DP, Leary M, Weidman EK, Herzberg DL, Vanden Hoek TL, et al.: Rescuer fatigue during actual in-hospital cardiopulmonary resuscitation with audiovisual feedback: a prospective multicenter study. Resusc 2009, 80:981-984.
- [10]Hightower D, Thomas SH, Stone CK, Dunn K, March JA: Decay in quality of closed-chest compressions over time. Ann Emerg Med 1995, 26:300-303.
- [11]Handley AJ, Handley SA: Improving CPR performance using an audible feedback system suitable for incorporation into an automated external defibrillator. Resusc 2003, 57:57-62.
- [12]Bjorshol CA, Sunde K, Myklebust H, Assmus J, Soreide E: Decay in chest compression quality due to fatigue is rare during prolonged advanced life support in a manikin model. Scand J Trauma Resusc Emerg Med 2011, 19:46. BioMed Central Full Text
- [13]Lexow K, Sunde K: Why Norwegian 2005 guidelines differs slightly from the ERC guidelines. Resusc 2007, 72:490-492.
- [14]Jantti H, Silfvast T, Turpeinen A, Kiviniemi V, Uusaro A: Quality of cardiopulmonary resuscitation on manikins: on the floor and in the bed. Acta Anaesthesiol Scand 2009, 53:1131-1137.