Comparison of quality of chest compressions during training of laypersons using Push Heart and Little Anne manikins using blinded CPRcards

Mass Cardio-Pulmonary Resuscitation (CPR) training using less expensive and easily portable manikins is one way to increase the number of trained laypeople in a short time. The easy-to-carry, low-cost CPR training model called Push Heart (PH) is widely used in Japan. The aim of this study was to examine if PH can achieve chest compression quality that is similar to that using more conventional Little Anne (LA) manikins for training laypersons.

This prospective randomized crossover study was done during routine community CPR training of laypersons in Singapore. The participants were randomly allocated into two groups, using the PH and LA models respectively. They crossed over during the training so that both groups had measurements using both models. Chest compression data were collected using blinded CPRcards, which are credit card-sized devices with accelerometers and data capture. Participants did not receive any CPR feedback during measurement.

Forty-two people had data captured for the study with 15 males. The median compression depth was 41.5 mm on LA and 38.0 mm on PH (p = 0.0664), and median compression rate was 105 cpm on LA and 103 cpm on PH (p = 0.2429). Overall, only 1.5% of compressions performed on the PH achieved adequate depth of between 50–70 mm compared to 5.5% achieved on LA (p = 0.049). In contrast, 84% of all compressions performed on the PH were within the adequate rate of 100–120 cpm compared to 79.5% on LA (p = 0.457). Only the under 20-year-old group was able to achieve adequate median compression depth (50.5 mm) on LA, while the older age groups did not (p = 0.0024). The other age groups performed similar quality of chest compression regardless of the model used. 73.8% of participants preferred the LA for training. After the training, participants felt similarly well-prepared with either model with a median score of 8/10 on LA compared to 7/10 on PH (p = 0.0011).

The PH can be an alternative mass CPR training model. Both models achieved satisfactory chest compression rates, but the majority of participants, especially the elderly, had difficulty achieving adequate depth.