Metronome Guided CPR to Improve the Quality of CPR

ABSTRACT

PURPOSE: Consensus guidelines clearly define how cardiopulmonary resuscitation (CPR) is to be performed, but the parameters of CPR in actual practice are not routinely measured, nor is the quality known. We sought to investigate the actual quality of CPR performed by trained hospital staffs and to determine whether metronome guidance improved the quality of CPR. METHODS: A prospective study was performed on 26 out of hospital cardiac arrest patients who received CPR at an emergency department (ED). In the ED, resuscitation efforts were recorded by using a camcorder. Using the recorded data, we analyzed the parameters of CPR quality such as ventilation and chest compression rates. RESULTS: In the 26 cardiac arrests, the first nine cases constituted group I. The subsequent nine cases, after the rescuers had been re-trained to provide CPR according to the guideline, constituted group II. The final eight cases after the rescuers had been trained to use metronome guidance constituted group III. The average ventilation rate in group I was 30.7 ventilations/min. Although the average ventilation rate in group II was lower than that of group I, it was still higher than the recommended rate. After metronome guidance, the ventilation rate was significantly reduced and approached to the rate of the present guideline. The average chest compression rate in group I was higher than the rate recommended in the present guideline and was significantly reduced after metronome guidance. CONCLUSION: We strongly believe that further study should be performed to consider the survival benefit of good-quality CPR. Devices providing feedback to alert rescuers may be useful for improving the quality of CPR.