CPR Feedback – You Better Know Your Coach (1090-000121) (Research Abstract Oral: Resuscitation)
Start time: Monday, January 25, 2021, 3:30 PM End time: Monday, January 25, 2021, 4:30 PM Session Type: Research Abstracts (Completed Studies)
The American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care identify high-quality cardiopulmonary resuscitation (CPR) as the primary component in influencing survival from cardiac arrest(1). Nowadays manikins are capable of providing real time feedback on rate and depth of compression, as well as other markers of quality CPR. Also, some newer medical devices, commonly used during resuscitation, can give visual feedback and provide verbal coaching to the code team to help improve the quality of chest compressions during a code(2). To encourage deliberate practice, simulation equipment is frequently used to offer immediate feedback on the quality of chest compressions and ventilation(3). These various devices use different mechanisms to measure the effectiveness of chest compressions. We compared the feedback from commonly used medical equipment using internal and external methods to determine quality of CPR on manikins.
Compressions were performed by certified BLS or ACLS instructors, who were giving chest compressions to AHA recommended depths at 2 and 2.5 inches for 30 second time periods. We compared depth of compression determined by external accelerometer measurement (Real CPR Help, ZOLL® R series® defibrillator) to the CPR feedback from a high fidelity manikin (QCPR, SimMan 3G, Laerdal, Stavanger, Norway) and a moderate fidelity manikin (voice activated manikin (VAM) Laerdal, Stavenger, Norway) using their internal method to measure depth of compressions. To eliminate human error we also compared the feedback from the external and internal measurement methods using an automatic CPR device (LUCAS®2 Physio Control, Redmont, WA).
Data was analyzed using a two tailed t-test for comparison. There was a significant difference comparing the feedback from all of the devices tested in this study. The depth measured by the voice activated manikin (average 40.7 mm, SD 4.7) was significantly higher than results for the high fidelity manikin (30.7mm, SD 1.7, p<0.05), which share the same manufacturer, but slightly different internal mechanism. Using the automatic CPR device, the feedback from the defibrillator using external measurement methods was significantly higher (75.3mm, SD 0.9) than the depth measured by internal methods within the manikin torso (59.3mm, SD 0.5, p<0.05).
More and more medical devices and simulation training equipment are capable to provide important feedback about quality of chest compressions in real time and immediately after a code (mock or real). However, the methods used to measure the quality of compressions are highly variable and the limitations of the various methods have to be understood. We found that the manikins used for practice of basic life support skills provide significantly different haptic and quality feedback than equipment used during mock code drills and real codes. This might lead to overestimating the quality of compressions in certain clinical environments. In the worst case, this can give a false sense of accuracy and lead to reduced quality of care.