Real-time Objective Feedback for Infant CPR Using a Novel New Infant Manikin - a Pilot Study - with Pediatric Nurses (1090-004172) (Research Abstract Professor Rounds: Group 2)
Start time: Thursday, January 28, 2021, 10:00 AM End time: Thursday, January 28, 2021, 11:00 AM Session Type: Research Abstracts (Completed Studies)
Cardiac arrest in infants is rare but is associated with an overall mortality of up to 90%.1 The majority of infants suffering from cardiac arrest have a poor chance of survival compared with older children. Providing adequate chest compressions and correct ventilation technique is essential during infant CPR but has been reported to be challenging to achieve in practice.2 Previous studies have found that frequent use of real time feedback can improve infant CPR performance.3,4 CPR feedback devices are recomended during CPR training to help improve skills.5 The hypothesis for this pilot study is to investigate whether it is possible to identify components of infant CPR that improve with practice (using objective and visual feedback). The objective was to investigate which components of infant CPR improve with practice with objective feedback from an infant manikin.
Using a realistic simulation environment, 10 paediatric nurses were assessed whilst performing infant CPR using ERC Guidelines.6 This was done in 3 steps. The infant manikin was Brayden Baby ProTM intended to represent a 6kg infant in this scenario. 1. Five rescue breaths followed by three cycles (15:2) of infant CPR. No feedback from the manikin was provided and no debrief. The overall CPR quality (%) and individual numeric CPR component data were recorded. 2. A short period (max 3 minutes) of guided and free practice with the real time feedback from the manikin switched on for the nurse. 3. Repetition of 1. A questionnaire to assess ease of use of the manikin was completed by each nurse individually at the end of Stage 3 using a Likert 10 point score. The manikin objective data collected for Stage 1 and 3 was analysed with descriptive (central tendency and distribution) and inferential statistical analysis (paired samples t-test). The level of significance used was set at a=.05.
The result shows that the overall mean infant CPR score improved from 64% at Step 1 to 82% at Step 3 (p=.00). The mean value for good compression depth (approximately 3,8 to 4 cm) improved from 34% to 72% (p=.01). The mean value for ‘over compression’ decreased from 61% to 5% respectively (p=.00). Good compression rate, 100–120 comp/min, increased from 23% at Step 1 to 47% in Step 3 (p=.02). Good compression release (0 mm), increased from 80% at Step 1 to 90% at Step 3. Correspondingly, incomplete compression release decreased from 20% to 10% from Step 1 to 3. Accuracy of finger (or thumb position when hand encircling technique was used) was 100% in both Step 1 and 3. The ventilation volume of 3-7 ml per kg of infant weight, (approx. to 5 ml x 6 kg = 30 ml), decreased from 46 ml to 43 ml (p=.04). The mean value for over ventilation volume decreased from 82% to 65% between Step 1 and 3. The mean score for ease of use obtained from the completed questionnaires was 9.2 (SD 1.9).
Continual quality assurance of CPR performance using real time objective feedback via visual and numeric means, together with repetitive practical training, enhances the quality of infant CPR.7,8 The results show guided and free practice with visual feedback (which is easy and quickly understood by the student) when used for infant CPR training improves the overall performance (i.e correct compression depth, rate, release and ventilation volume). These key components of the paediatric CPR guidelines ensure high-quality infant CPR9 as they are essential for maintaining vital organ perfusion.10 Infant CPR is difficult to perform within the correct parameters, even for highly skilled providers, so training manikins that help improve and optimize performance and are easy to understand and use should be employed where applicable. This result is consistent with this statement and the questionnaire results suggest the new manikin helped improve performance and is easy to understand and use.