Real-Time Cardiopulmonary Resuscitation Feedback and Targeted Training Improve Chest Compression Performance in a Cohort of International Healthcare Providers

BackgroundOptimal cardiopulmonary resuscitation (CPR) performance is the foundation of successful cardiac arrest resuscitation. However, health care providers perform inadequate compressions. Better training techniques and real-time CPR feedback may improve compression performance.ObjectiveWe sought to evaluate the impact of a targeted training program combined with real-time defibrillator CPR feedback on chest compression performance in an international cohort of health care providers.MethodsPhysicians, nurses, respiratory therapists, and technicians from 6 hospitals in 5 countries (Taiwan, Singapore, China, Bahrain, and Kuwait) participated in a standardized resuscitation workshop. Chest compression was measured before and after didactics and activation of CPR feedback. Compressions were performed for 1 min on standard CPR manikins placed on a hospital bed and backboard and measured using ZOLL R Series defibrillators. The percentage of compressions meeting target values for depth and rate were compared before and after the workshop and activation of real-time CPR feedback. No depth maximum was defined to allow for mattress compression.ResultsChest compressions were more likely to meet targets for depth (71–95%, odds ratio [OR] 8.61 [95% confidence interval {CI} 4.42–16.77], p < 0.001), rate (41–81%, OR 6.4 [95% CI 4.2–9.8], p < 0.001), and both depth and rate (5–42%, OR 2.4 [95% CI 6.7–22.9], p < 0.001) after the workshop and activation of real-time CPR feedback.ConclusionsA targeted training intervention combined with real-time CPR feedback improved chest compression performance among health care providers from various countries.