Can real-time feedback improve the simulated infant cardiopulmonary resuscitation performance of basic life support and lay rescuers?

Arch Dis Child. 2019 Aug;104(8):793-801. doi: 10.1136/archdischild-2018-316576. Epub 2019 Jun 4.

Abstract

Background: Performing high-quality chest compressions during cardiopulmonary resuscitation (CPR) requires achieving of a target depth, release force, rate and duty cycle.

Objective: This study evaluates whether 'real time' feedback could improve infant CPR performance in basic life support-trained (BLS) and lay rescuers. It also investigates whether delivering rescue breaths hinders performing high-quality chest compressions. Also, this study reports raw data from the two methods used to calculate duty cycle performance.

Methodology: BLS (n=28) and lay (n=38) rescuers were randomly allocated to respective 'feedback' or 'no-feedback' groups, to perform two-thumb chest compressions on an instrumented infant manikin. Chest compression performance was then investigated across three compression algorithms (compression only; five rescue breaths then compression only; five rescue breaths then 15:2 compressions). Two different routes to calculate duty cycle were also investigated, due to conflicting instruction in the literature.

Results: No-feedback BLS and lay groups demonstrated <3% compliance against each performance target. The feedback rescuers produced 20-fold and 10-fold increases in BLS and lay cohorts, respectively, achieving all targets concurrently in >60% and >25% of all chest compressions, across all three algorithms. Performing rescue breaths did not impede chest compression quality.

Conclusions: A feedback system has great potential to improve infant CPR performance, especially in cohorts that have an underlying understanding of the technique. The addition of rescue breaths-a potential distraction-did not negatively influence chest compression quality. Duty cycle performance depended on the calculation method, meaning there is an urgent requirement to agree a single measure.

Keywords: resuscitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bystander Effect
  • Cardiopulmonary Resuscitation / instrumentation*
  • Child Health Services
  • Computer Simulation
  • Feedback*
  • Female
  • Heart Arrest / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Manikins*
  • Treatment Outcome