title: Effects of flashlight guidance on chest compression performance in cardiopulmonary resuscitation in a noisy environment.
abstract: BACKGROUND
  In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether 'flashlight' guidance influences CPR performance in a simulated noisy setting.
  
  
  METHODS
  We recruited 30 senior medical students with no previous experience of using flashlight-guided CPR to participate in this prospective, simulation-based, crossover study. The experiment was conducted in a simulated noisy situation using a cardiac arrest model without ventilation. Noise such as patrol car and fire engine sirens was artificially generated. The flashlight guidance device emitted light pulses at the rate of 100 flashes/min. Participants also received instructions to achieve the desired rate of 100 compressions/min. CPR performances were recorded with a Resusci Anne mannequin with a computer skill-reporting system.
  
  
  RESULTS
  There were significant differences between the control and flashlight groups in mean compression rate (MCR), MCR/min and visual analogue scale. However, there were no significant differences in correct compression depth, mean compression depth, correct hand position, and correctly released compression. The flashlight group constantly maintained the pace at the desired 100 compressions/min. Furthermore, the flashlight group had a tendency to keep the MCR constant, whereas the control group had a tendency to decrease it after 60 s.
  
  
  CONCLUSIONS
  Flashlight-guided CPR is particularly advantageous for maintaining a desired MCR during hands-only CPR in noisy environments, where metronome pacing might not be clearly heard.
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.forename: Sung Phil
authors.initials: SP
authors.lastname: Chung
authors.forename: Chul Ho
authors.initials: CH
authors.lastname: Chang
authors.forename: Incheol
authors.initials: I
authors.lastname: Park
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.forename: SeungHo
authors.initials: S
authors.lastname: Kim
authors.forename: Hahn Shick
authors.initials: HS
authors.lastname: Lee
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D003258:Consumer Behavior; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D009622:Noise; D010775:Photic Stimulation / Q000379:methods