Feedback devices seem to improve compliance to Guidelines in CPR. Are there any outcome studies proving improved outcomes (i.e. ROSC, admission to hospital) in humans?
As i know , chest wall compression is a time saver skill .
without chest wall compression in a cardiac arrest man we have 8 % - 10% decrease per minute in probability of revive - if we start chest wall compression as soon as possible the rate reach to 3%-4% per min . so the time is longer .
regards
Direct and constructive feedback, whether in healthcare or in industry, has been associated with some degree of objective and subjective improvement.
See: http://www.resuscitationjournal.com/article/S0300-9572%2809%2900186-5/abstract?cc=y
This ítem was extensively discussed during the 2015 ILCOR International Consensus on CPR & ECC Science. As far as an "embargo" was imposed to all participants of the meeting untill ILCOR will publish them, I cannot transmit you the results of this question. Personally I strongly agree with the point of view that visual (or audio-visual) aids can improve CPR performance.
Until the new guidelines (and the science behind them) will be published, we have to go with the old CoSTR documents (Consensus on CPR and ECC Science and Treatment Recommendations - part 1, executive summary: While the document states that feedback devices might improve the quality of chest compressions during an actual CPR, it also points to its value during training/education. Its use during training should be encouraged - let alone the use during actual CPRs.
For a period of some years, CPR was not trained at our hospital (due to an administrative failure). We studied the possible change in survival and compared the period before with the period after CPR training. In total, there were 73 in-hospital cardiac arrests (CAs) during a period of 12 months before and 133 during 18 months after the intervention, which lasted 23 months. The overall delay to defibrillation was not reduced after the intervention, and the proportion of survivors to hospital discharge was 26% before and 32% after the intervention (P = 0.51). Cerebral function, however, was improved after the intervention (as judged by the cerebral performance categories score; P < 0.001). The proportion of survivors among all CA patients discharged with a cerebral performance scale score of 1 or 2 (good or acceptable cerebral function) increased from 20% to 32%.
Källestedt ML, Berglund A, Enlund M, Herlitz J. In-hospital cardiac arrest characteristics and outcome after defibrillator implementation and education: from 1 single hospital in Sweden. Am J Emerg Med. 2012;30:1712-8.
Dear Paul, I Think that Answer is YES! Look This Attachment:
"Depth, Rate of Chest Compressions During CPR Impact Survival in Cardiac Arrest" - Febbraio 6, 2015
DALLAS, Tex -- February 6, 2015 -- The depth of chest compressions and the rate at which they were applied make a significant impact on survival and recovery of patients, according to 2 studies published in Circulation and Critical Care Medicine.
Contrary to popular belief, the studies showed that cardiopulmonary resuscitation (CPR) compressions deeper than 5.5 cm resulted in decreased survival, possibly because of collateral damage to other internal organs.
Previously, investigations and guidelines indicated that deeper compressions were better. The American Heart Association's (AHA) 2010 CPR guidelines recommend compressing the chest at least 5 cm without providing any upper limit.
“Most people do not recognise that it takes quite a bit of thrust to compress the chest 2 inches,” said Ahamed Idris, MD, by UT Southwestern Medical Center, Dallas, Texas. “About 60 pounds [27 kg] of pressure are required to reach this depth, but in some cases a burly fireman or well-intended volunteer can go way past that amount, which can harm the patient.”
The researchers also found that the rate at which chest compression was applied was most important. Compression rates of 100 to 120 per minute were optimal for survival when other factors were considered.
“Survival depends on the quality of the CPR,” said Dr. Idris. “Both the depth of chest compressions and the rate at which they are applied can have important results for patients in the first moments of cardiac arrest.”
About half of responders are giving chest compressions too fast, with about a third above 120 compressions per minute, and 20% above 140 per minute, said Dr. Idris.
The researchers will continue to oversee innovative clinical trials to test the early delivery of interventions for serious trauma and cardiac arrest as part of a federally funded consortium aimed at advancing prehospital emergency care.
The Resuscitation Outcomes Consortium (ROC) has enrolled tens of thousands of patients to test prehospital interventions to improve outcomes in severely ill or injured patients before they are transported to a hospital.
SOURCE: University of Texas Southwestern Medical Center
Yes They do.
ilcor 2015 Guidelines recomend cpr Feedback devices AT all times.
all aha courses (bLS, als, pals) must use it during training.
the recent CoSTR (erc 2019) still recomend it.
this are the articles that aha uses in 2015 to recomend the use of CPR Feedback device.
Oh JH, Lee SJ, Kim SE, Lee KJ, Choe JW, Kim CW. Effects of audio tone guidance on performance of CPR in simulated cardiac arrest with an advanced airway. Resuscitation. 2008;79:273–277. doi: 10.1016/j. resuscitation.2008.06.022.
Woollard M, Poposki J, McWhinnie B, Rawlins L, Munro G, O’Meara P. Achy breaky makey wakey heart? A randomised crossover trial of musical prompts. Emerg Med J. 2012;29:290–294. doi: 10.1136/ emermed-2011-200187.
Dear Nelson, thank you for your answer. As i understand it this is about frequency prompts, but not depht. This is half the story of compression feedback. Kind regards Paul v Berkom.