title: Quality of closed chest compression on a manikin in ambulance vehicles and flying helicopters with a real time automated feedback.
abstract: BACKGROUND
  Automated verbal and visual feedback improves quality of resuscitation in out-of-hospital cardiac arrest and was proven to increase short-term survival. Quality of resuscitation may be hampered in more difficult situations like emergency transportation. Currently there is no evidence if feedback devices can improve resuscitation quality during different modes of transportation.
  
  
  OBJECTIVE
  To assess the effect of real time automated feedback on the quality of resuscitation in an emergency transportation setting.
  
  
  METHODS
  Randomised cross-over trial.
  
  
  METHODS
  Medical University of Vienna, Vienna Municipal Ambulance Service and Helicopter Emergency Medical Service Unit (Christophorus Flugrettungsverein) in September 2007.
  
  
  METHODS
  European Resuscitation Council (ERC) certified health care professionals performing CPR in a flying helicopter and in a moving ambulance vehicle on a manikin with human-like chest properties.
  
  
  METHODS
  CPR sessions, with real time automated feedback as the intervention and standard CPR without feedback as control.
  
  
  METHODS
  Quality of chest compression during resuscitation.
  
  
  RESULTS
  Feedback resulted in less deviation from ideal compression rate 100 min(-1) (9+/-9 min(-1), p<0.0001) with this effect becoming steadily larger over time. Applied work was less in the feedback group compared to controls (373+/-448 cm x compression; p<0.001). Feedback did not influence ideal compression depth significantly. There was some indication of a learning effect of the feedback device.
  
  
  CONCLUSIONS
  Real time automated feedback improves certain aspects of CPR quality in flying helicopters and moving ambulance vehicles. The effect of feedback guidance was most pronounced for chest compression rate.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
authors.forename: Christof
authors.initials: C
authors.lastname: Havel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schreiber
authors.forename: Helmut
authors.initials: H
authors.lastname: Trimmel
authors.forename: Reinhard
authors.initials: R
authors.lastname: Malzer
authors.forename: Moritz
authors.initials: M
authors.lastname: Haugk
authors.forename: Nina
authors.initials: N
authors.lastname: Richling
authors.forename: Eva
authors.initials: E
authors.lastname: Riedmüller
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
authors.forename: Harald
authors.initials: H
authors.lastname: Herkner
mesh_terms: D000328:Adult; D017732:Air Ambulances; D000552:Ambulances; D001331:Automation; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000592:standards*; D018592:Cross-Over Studies; D056228:Feedback, Sensory; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000295:instrumentation* / Q000592:standards*; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged