title: Real-time feedback can improve infant manikin cardiopulmonary resuscitation by up to 79%--a randomised controlled trial.
abstract: METHODS
  European and Advanced Paediatric Life Support training courses.
  
  
  METHODS
  Sixty-nine certified CPR providers.
  
  
  METHODS
  CPR providers were randomly allocated to a 'no-feedback' or 'feedback' group, performing two-thumb and two-finger chest compressions on a "physiological", instrumented resuscitation manikin. Baseline data was recorded without feedback, before chest compressions were repeated with one group receiving feedback.
  
  
  METHODS
  Indices were calculated that defined chest compression quality, based upon comparison of the chest wall displacement to the targets of four, internationally recommended parameters: chest compression depth, release force, chest compression rate and compression duty cycle.
  
  
  RESULTS
  Baseline data were consistent with other studies, with <1% of chest compressions performed by providers simultaneously achieving the target of the four internationally recommended parameters. During the 'experimental' phase, 34 CPR providers benefitted from the provision of 'real-time' feedback which, on analysis, coincided with a statistical improvement in compression rate, depth and duty cycle quality across both compression techniques (all measures: p<0.001). Feedback enabled providers to simultaneously achieve the four targets in 75% (two-finger) and 80% (two-thumb) of chest compressions.
  
  
  CONCLUSIONS
  Real-time feedback produced a dramatic increase in the quality of chest compression (i.e. from <1% to 75-80%). If these results transfer to a clinical scenario this technology could, for the first time, support providers in consistently performing accurate chest compressions during infant CPR and thus potentially improving clinical outcomes.
authors.affiliation: Institute of Medical Engineering and Medical Physics, Cardiff University, The Parade, Cardiff CF24 3AA, United Kingdom.
authors.forename: Philip
authors.initials: P
authors.lastname: Martin
authors.forename: Peter
authors.initials: P
authors.lastname: Theobald
authors.forename: Alison
authors.initials: A
authors.lastname: Kemp
authors.forename: Sabine
authors.initials: S
authors.lastname: Maguire
authors.forename: Ian
authors.initials: I
authors.lastname: Maconochie
authors.forename: Michael
authors.initials: M
authors.lastname: Jones
mesh_terms: D000328:Adult; D001296:Audiovisual Aids; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000379:methods / Q000592:standards; D002983:Clinical Competence; D003479:Curriculum; D004521:Educational Measurement / Q000379:methods; D060731:Emergency Responders / Q000193:education*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008348:Manikins; D017145:Models, Educational; D058996:Quality Improvement; D013663:Teaching / Q000379:methods*; D006113:United Kingdom
keywords: Cardiopulmonary resuscitation; Chest compression; Feedback; Infant; Manikins; Paediatric