Short structured feedback training is equivalent to a mechanical feedback device in two-rescuer BLS: a randomised simulation study

Scand J Trauma Resusc Emerg Med. 2016 May 13;24:70. doi: 10.1186/s13049-016-0265-9.


Background: Resuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest. Whether effective continuous feedback could also be given verbally by a second rescuer ("human feedback") has not been investigated yet. We, therefore, compared the effect of human feedback to a CPR feedback device.

Methods: In an open, prospective, randomised, controlled trial, we compared CPR performance of three groups of medical students in a two-rescuer scenario. Group "sCPR" was taught standard BLS without continuous feedback, serving as control. Group "mfCPR" was taught BLS with mechanical audio-visual feedback (HeartStart MRx with Q-CPR-Technology™). Group "hfCPR" was taught standard BLS with human feedback. Afterwards, 326 medical students performed two-rescuer BLS on a manikin for 8 min. CPR quality parameters, such as "effective compression ratio" (ECR: compressions with correct hand position, depth and complete decompression multiplied by flow-time fraction), and other compression, ventilation and time-related parameters were assessed for all groups.

Results: ECR was comparable between the hfCPR and the mfCPR group (0.33 vs. 0.35, p = 0.435). The hfCPR group needed less time until starting chest compressions (2 vs. 8 s, p < 0.001) and showed fewer incorrect decompressions (26 vs. 33 %, p = 0.044). On the other hand, absolute hands-off time was higher in the hfCPR group (67 vs. 60 s, p = 0.021).

Conclusions: The quality of CPR with human feedback or by using a mechanical audio-visual feedback device was similar. Further studies should investigate whether extended human feedback training could further increase CPR quality at comparable costs for training.

Keywords: Basic life support (BLS); Cardiopulmonary resuscitation (CPR); Feedback device.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cardiopulmonary Resuscitation / education*
  • Cardiopulmonary Resuscitation / instrumentation
  • Education, Medical / methods*
  • Equipment Design
  • Feedback*
  • Female
  • Follow-Up Studies
  • Heart Massage / methods*
  • Humans
  • Male
  • Manikins*
  • Pressure
  • Prospective Studies
  • Students, Medical / psychology*
  • Thorax
  • Young Adult