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BMC Emergency Medicine

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Open Access 01-12-2020 | Cardiopulmonary Resuscitation | Research article

Evaluation of manual chest compressions according to the updated cardiopulmonary resuscitation guidelines and the impact of feedback devices in an educational resuscitation course

Authors: Nao Urushibata, Kiyoshi Murata, Hideki Endo, Ayako Yoshiyuki, Yasuhiro Otomo

Published in: BMC Emergency Medicine | Issue 1/2020

Abstract

Background

The cardiopulmonary resuscitation guidelines revised in 2015 recommend target chest compression rate (CCR) and chest compression depth (CCD) of 100–120 compressions per minute (cpm) and 5–6 cm, respectively. We hypothesized that the new guidelines are harder to comply with, even with proper feedback.

Methods

This prospective observational study using data collected from the participants of an Immediate Cardiac Life Support course included the evaluation of chest compressions using performance data from a feedback device after the completion of the course. Participants completed chest compressions for 1 min and were provided with feedback, after which they performed another cycle of CC. Primary outcome measures were CCR and CCD as well as the correct CCR percentage and CCD percentage for pre and post feedback.

Results

The study included a total of 88 participants. The median pre-CCR was 112.5 cpm (interquartile range [IQR] 108–116 cpm), and the median correct pre-CCR percentage was 96% (IQR 82.5–99.5%). After the feedback, there was a slight increase in the correct CCR percentage (99% [IQR 92.5–100%]). Conversely, the median pre-CCD was 5.4 cm (IQR 4.9–5.8 cm), and the median pre-correct CCD percentage was 66% (IQR 18.5–90%). The increase in the median post-correct CCD percentage to 72% (IQR 27–94%) observed after the feedback was not statistically significant (P = 0.361).

Conclusions

Compliance with the new guidelines for chest compressions, especially those regarding the CCD, might be difficult. However, whether the changes in guidelines affect outcomes in actual clinical settings is uncertain and requires further investigation.

Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, et al. European resuscitation council guidelines for resuscitation 2015. Resuscitation. 2015;95:1–80. https://doi.org/10.1016/j.resuscitation.2015.07.038.CrossRefPubMed

Bhanji F, Donoghue AJ, Wolff MS, Flores GE, Halamek LP, Berman JM, et al. Part 14: education: 2015 american heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S561–73. https://doi.org/10.1161/CIR.0000000000000268.CrossRefPubMed

Kitamura T, Iwami T, Atsumi T, Endo T, Kanna T, Kuroda Y, et al. The profile of Japanese Association for Acute Medicine - out-of-hospital cardiac arrest registry in 2014-2015. Acute Med Surg. 2018;5:249–58. https://doi.org/10.1002/ams2.340.CrossRefPubMedPubMedCentral

https://www.fdma.go.jp/publication/rescue/items/kkkg_h30_01_kyukyu.pdf. https://www.fdma.go.jp/publication/rescue/items/kkkg_h30_01_kyukyu.pdf. Accessed 5 Dec 2019.

Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, et al. European resuscitation council guidelines for resuscitation 2015: section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015;95:81–99. https://doi.org/10.1016/j.resuscitation.2015.07.015.CrossRefPubMed

Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: executive summary: 2015 american heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S315–67. https://doi.org/10.1161/CIR.0000000000000252.CrossRefPubMed

Okudera H, Wakasugi M. Immediate Cardiac Life Support (ICLS) course developed by Japanese Association for Acute Medicine. Nippon Rinsho. 2011;69:684–90.PubMed

Japan Resuscitation Council, editor. Japanese guidelines for emergency care and cardiopulmonary resuscitation. Tokyo: Igaku-shoin; 2015. p. 2016.

Duval S, Pepe PE, Aufderheide TP, Goodloe JM, Debaty G, Labarère J, et al. Optimal combination of compression rate and depth during cardiopulmonary resuscitation for functionally favorable survival. JAMA Cardiol. 2019. https://doi.org/10.1001/jamacardio.2019.2717.

10.

Nolan J, Soar J, Eikeland H. The chain of survival. Resuscitation. 2006;71:270–1. https://doi.org/10.1016/j.resuscitation.2006.09.001.CrossRefPubMed

11.

Nassar BS, Kerber R. Improving CPR performance. Chest. 2017;152:1061–9. https://doi.org/10.1016/j.chest.2017.04.178.CrossRefPubMed

12.

Yeung J, Meeks R, Edelson D, Gao F, Soar J, Perkins GD. The use of CPR feedback/prompt devices during training and CPR performance: a systematic review. Resuscitation. 2009;80:743–51. https://doi.org/10.1016/j.resuscitation.2009.04.012.CrossRefPubMed

13.

Spooner BB, Fallaha JF, Kocierz L, Smith CM, Smith SCL, Perkins GD. An evaluation of objective feedback in basic life support (BLS) training. Resuscitation. 2007;73:417–24. https://doi.org/10.1016/j.resuscitation.2006.10.017.CrossRefPubMed

14.

Liu Y, Huang Z, Li H, Zheng G, Ling Q, Tang W, et al. CPR feedback/prompt device improves the quality of hands-only CPR performed in manikin by laypersons following the 2015 AHA guidelines. Am J Emerg Med. 2018;36:1980–5. https://doi.org/10.1016/j.ajem.2018.02.034.CrossRefPubMed

15.

Lynch B, Einspruch EL, Nichol G, Aufderheide TP. Assessment of BLS skills: optimizing use of instructor and manikin measures. Resuscitation. 2008;76:233–43. https://doi.org/10.1016/j.resuscitation.2007.07.018.CrossRefPubMed

16.

Stiell IG, Brown SP, Nichol G, Cheskes S, Vaillancourt C, Callaway CW, et al. What is the optimal chest compression depth during out-of-hospital cardiac arrest resuscitation of adult patients? Circulation. 2014;130:1962–70. https://doi.org/10.1161/CIRCULATIONAHA.114.008671.CrossRefPubMed

17.

Buléon C, Delaunay J, Parienti J-J, Halbout L, Arrot X, Gérard J-L, et al. Impact of a feedback device on chest compression quality during extended manikin CPR: a randomized crossover study. Am J Emerg Med. 2016;34:1754–60. https://doi.org/10.1016/j.ajem.2016.05.077.CrossRefPubMed

Title: Evaluation of manual chest compressions according to the updated cardiopulmonary resuscitation guidelines and the impact of feedback devices in an educational resuscitation course
Authors: Nao Urushibata
Kiyoshi Murata
Hideki Endo
Ayako Yoshiyuki
Yasuhiro Otomo
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Cardiopulmonary Resuscitation
Published in: BMC Emergency Medicine / Issue 1/2020
Electronic ISSN: 1471-227X
DOI: https://doi.org/10.1186/s12873-020-00345-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of manual chest compressions according to the updated cardiopulmonary resuscitation guidelines and the impact of feedback devices in an educational resuscitation course

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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