A randomised control trial of prompt and feedback devices and their impact on quality of chest compressions--a simulation study.
OBJECTIVE
This study aims to compare the effect of three CPR prompt and feedback devices on quality of chest compressions amongst healthcare providers.


METHODS
A single blinded, randomised controlled trial compared a pressure sensor/metronome device (CPREzy), an accelerometer device (Phillips Q-CPR) and simple metronome on the quality of chest compressions on a manikin by trained rescuers. The primary outcome was compression depth. Secondary outcomes were compression rate, proportion of chest compressions with inadequate depth, incomplete release and user satisfaction.


RESULTS
The pressure sensor device improved compression depth (37.24-43.64 mm, p=0.02), the accelerometer device decreased chest compression depth (37.38-33.19 mm, p=0.04) whilst the metronome had no effect (39.88 mm vs. 40.64 mm, p=0.802). Compression rate fell with all devices (pressure sensor device 114.68-98.84 min(-1), p=0.001, accelerometer 112.04-102.92 min(-1), p=0.072 and metronome 108.24 min(-1) vs. 99.36 min(-1), p=0.009). The pressure sensor feedback device reduced the proportion of compressions with inadequate depth (0.52 vs. 0.24, p=0.013) whilst the accelerometer device and metronome did not have a statistically significant effect. Incomplete release of compressions was common, but unaffected by the CPR feedback devices. Users preferred the accelerometer and metronome devices over the pressure sensor device. A post hoc study showed that de-activating the voice prompt on the accelerometer device prevented the deterioration in compression quality seen in the main study.


CONCLUSIONS
CPR feedback devices vary in their ability to improve performance. In this study the pressure sensor device improved compression depth, whilst the accelerometer device reduced it and metronome had no effect.
Academic Department of Critical Care, Anaesthesia and Pain, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; University of Birmingham, College of Medical and Dental Studies, B15 2TT, UK.
Joyce
J
Yeung
University of Warwick, Warwick Medical School, CV4 7AL, UK.
Robin
R
Davies
Academic Department of Critical Care, Anaesthesia and Pain, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; University of Birmingham, College of Medical and Dental Studies, B15 2TT, UK.
Fang
F
Gao
Academic Department of Critical Care, Anaesthesia and Pain, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK; University of Warwick, Warwick Medical School, CV4 7AL, UK. Electronic address: g.d.perkins@warwick.ac.uk.
Gavin D
GD
Perkins
D061725:Accelerometry / Q000295:instrumentation; D000328:Adult; D049628:Body Size; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D003463:Cues; D056228:Feedback, Sensory; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D011312:Pressure; D011787:Quality of Health Care; D016037:Single-Blind Method; D055815:Young Adult
Chest compression; Education; Feedback devices; Training