title: How ABBA may help improve neonatal resuscitation training: auditory prompts to enable coordination of manual inflations and chest compressions.
abstract: OBJECTIVE
  Resuscitation guidelines recommend 90 chest compressions (CCs) and 30 inflations (INFs) per minute for neonatal cardiopulmonary resuscitation (nCPR). We hypothesised that auditory prompts would help coordinate these actions. Our aim was to investigate the effect of musical prompts during nCPR training on adherence to recommended CC and INF rates and on the quality of delivered INFs.
  
  
  METHODS
  A simulation study was conducted employing 30 experienced neonatal staff, a respiratory function monitor and a neonatal manikin. The effects of five different auditory prompts on adherence to recommended rates of CC and INF were tested against baseline (no music). The five auditory prompts (popular musical tunes) were investigated in random order. Quality of INFs was assessed by comparing the peak inflation pressures (PIP), positive end-expiratory pressures (PEEP), percentage mask leak and tidal volumes (VT).
  
  
  RESULTS
  Mean baseline rates at which CCs and INFs were delivered were 80 (SD 6) per minute and 28 (SD 2) per minute, respectively. Listening to auditory prompts had varying effects on CC and INF delivery rates. For CCs, a significant difference to baseline was found only when participants listened to ABBA's 'SOS', with 86 (SD 7) per minute (P = 0.04). For INFs, we found a statistically significant improvement to baseline rate only for 'SOS', with 29 (SD 2) per minute (P = 0.04), and there was no significant difference in INF quality among the auditory prompts.
  
  
  CONCLUSIONS
  Musical prompts can help with adherence to recommended CC and INF rates but do not improve the quality of INFs during nCPR training. The lasting effect of auditory prompts as musical mnemonics on nCPR performance in vivo needs to be established.
authors.affiliation: Neonatal Research Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia; The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia; Department of Neonatology, Charité University Medical Centre, Berlin, Germany.
authors.forename: Charles Christoph
authors.initials: CC
authors.lastname: Roehr
authors.forename: Georg M
authors.initials: GM
authors.lastname: Schmölzer
authors.forename: Marta
authors.initials: M
authors.lastname: Thio
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dawson
authors.forename: Simone Katrin
authors.initials: SK
authors.lastname: Dold
authors.forename: Gerd
authors.initials: G
authors.lastname: Schmalisch
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
mesh_terms: D001315:Australia; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D035641:Chest Wall Oscillation / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007327:Insufflation / Q000379:methods; D008297:Male; D008348:Manikins; D009146:Music; D017283:Neonatal Nursing / Q000193:education; D010348:Patient Care Team; D011175:Positive-Pressure Respiration / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy
keywords: chest compression; mask leak; music; neonatal resuscitation; positive-pressure ventilation; respiratory function monitor