Influence of chest compression rate guidance on the quality of cardiopulmonary resuscitation performed on manikins |
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| Authors: | H Jäntti T Silfvast A Turpeinen V Kiviniemi A Uusaro |
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| Institution: | 1. Department of Anaesthesia and Intensive Care, Kuopio University Hospital, PO Box 1777, FIN-70210 Kuopio, Finland;2. Department of Anaesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland;3. Unit of Cardiology, Kuopio University Hospital Finland, Kuopio, Finland;4. IT Centre, Statistical and Mathematical Services, University of Kuopio, Kuopio, Finland;1. Department of Anaesthesia, General Intensive Care and Pain Medicine, Medical University Vienna, Austria;2. Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Switzerland;3. Department of Family Medicine, Hospital of the Sisters of Charity Linz, Austria;4. Department of Anaesthesia, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical University Vienna, Austria;5. Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Austria;6. Department of Emergency Medicine, Medical University Vienna, Austria;7. Institute of Anaesthesiology, University Hospital Zürich, Zürich, Switzerland;8. Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria;9. Department of Anaesthesia, General Intensive Care and Pain Control, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Medical University Vienna, Austria;1. University of Toronto, Toronto, ON, Canada;2. University of Washington, Seattle, Washington, United States;3. University of British Columbia, Vancouver, British, Colombia;4. University of Ottawa (C.V.), Ottawa, ON, Canada;5. Oregon Health and Sciences University, Portland, Oregon, United States;6. University of Pittsburgh, Pittsburgh, Pennsylvania, United States;7. Medical College of Wisconsin, Milwaukee, Wisconsin, United States;8. Tualatin Valley Fire & Rescue, Portland, Oregon, United States;1. The Children''s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, United States;2. University of Pennsylvania, Department of Biostatistics and Epidemiology, 423 Guardian Drive, Philadelphia, PA 19104, United States;1. Icahn School of Medicine at Mount Sinai, New York, New York;2. Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York;3. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York |
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| Abstract: | AimsThe adequate chest compression rate during CPR is associated with improved haemodynamics and primary survival. To explore whether the use of a metronome would affect also chest compression depth beside the rate, we evaluated CPR quality using a metronome in a simulated CPR scenario.MethodsForty-four experienced intensive care unit nurses participated in two-rescuer basic life support given to manikins in 10 min scenarios. The target chest compression to ventilation ratio was 30:2 performed with bag and mask ventilation. The rescuer performing the compressions was changed every 2 min. CPR was performed first without and then with a metronome that beeped 100 times per minute. The quality of CPR was analysed with manikin software. The effect of rescuer fatigue on CPR quality was analysed separately.ResultsThe mean compression rate between ventilation pauses was 137 ± 18 compressions per minute (cpm) without and 98 ± 2 cpm with metronome guidance (p < 0.001). The mean number of chest compressions actually performed was 104 ± 12 cpm without and 79 ± 3 cpm with the metronome (p < 0.001). The mean compression depth during the scenario was 46.9 ± 7.7 mm without and 43.2 ± 6.3 mm with metronome guidance (p = 0.09). The total number of chest compressions performed was 1022 without metronome guidance, 42% at the correct depth; and 780 with metronome guidance, 61% at the correct depth (p = 0.09 for difference for percentage of compression with correct depth).ConclusionsMetronome guidance corrected chest compression rates for each compression cycle to within guideline recommendations, but did not affect chest compression quality or rescuer fatigue. |
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