The Effect of a Real Time Audiovisual Feedback System on the Quality of Chest Compressions by Trained Personnel during Resuscitation: A Randomized Controlled Trial using a Manikin Model

ABSTRACT

PURPOSE: The survival benefit to patients of high-quality cardiopulmonary resuscitation (CPR) is well-documented. In the 2005 resuscitation guidelines, the quality of CPR was emphasized and the monitoring of CPR quality variables broadly recommended. However, little objective data exist regarding the effect of a monitoring and feedback system on CPR quality variables during resuscitation. METHODS: Forty-nine volunteers among hospital nurses and doctors were randomly assigned to two groups and asked to perform five minutes of continuous chest compression on a manikin either with or without a real time audiovisual feedback system. The quality variables of chest compression including compression rate, compression depth, the proportion of adequate compression depth, and the proportion of complete recoil were recorded. RESULTS: Data from 25 chest compression episodes in the control group were compared to 24 episodes in the feedback group. There was a improvement in the mean compression rate in the feedback group with a statistically significant narrowing of distribution (107.4+/-19.3 to 102.9+/-5.7 /min; test of means, p=0.071; test of variance, p<0.001). There were statistically significant improvements in the mean values of other quality variables in the feedback group including compression depth (from 39.7+/-5.9 to 42.3+/-2.8 mm; test of means, p=0.039; test of variance, p=0.026), the proportion of adequate compression depth (from 65.8+/-33.5% to 86.9+/-16.2%; test of means, p=0.011; test of variance, p<0.001), and the proportion of incomplete recoil (44.6+/-34.9% to 16.3+/-19.2%; test of means, p=0.014; test of variance, p=0.005). CONCLUSION: In this study, we confirmed that a real time audiovisual feedback system significantly improve the quality of chest compression during resuscitation.