Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins

Resuscitation. 2009 Apr;80(4):453-7. doi: 10.1016/j.resuscitation.2009.01.001. Epub 2009 Feb 8.


Aims: The adequate chest compression rate during CPR is associated with improved haemodynamics and primary survival. To explore whether the use of a metronome would affect also chest compression depth beside the rate, we evaluated CPR quality using a metronome in a simulated CPR scenario.

Methods: Forty-four experienced intensive care unit nurses participated in two-rescuer basic life support given to manikins in 10min scenarios. The target chest compression to ventilation ratio was 30:2 performed with bag and mask ventilation. The rescuer performing the compressions was changed every 2min. CPR was performed first without and then with a metronome that beeped 100 times per minute. The quality of CPR was analysed with manikin software. The effect of rescuer fatigue on CPR quality was analysed separately.

Results: The mean compression rate between ventilation pauses was 137+/-18compressions per minute (cpm) without and 98+/-2cpm with metronome guidance (p<0.001). The mean number of chest compressions actually performed was 104+/-12cpm without and 79+/-3cpm with the metronome (p<0.001). The mean compression depth during the scenario was 46.9+/-7.7mm without and 43.2+/-6.3mm with metronome guidance (p=0.09). The total number of chest compressions performed was 1022 without metronome guidance, 42% at the correct depth; and 780 with metronome guidance, 61% at the correct depth (p=0.09 for difference for percentage of compression with correct depth).

Conclusions: Metronome guidance corrected chest compression rates for each compression cycle to within guideline recommendations, but did not affect chest compression quality or rescuer fatigue.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Acoustic Stimulation*
  • Adult
  • Attitude of Health Personnel
  • Cardiopulmonary Resuscitation / methods*
  • Cardiopulmonary Resuscitation / nursing
  • Critical Care
  • Cross-Over Studies
  • Fatigue / etiology
  • Female
  • Heart Massage*
  • Humans
  • Male
  • Manikins
  • Middle Aged
  • Periodicity*
  • Quality of Health Care*
  • Young Adult