title: Short structured feedback training is equivalent to a mechanical feedback device in two-rescuer BLS: a randomised simulation study.
abstract: BACKGROUND
  Resuscitation guidelines encourage the use of cardiopulmonary resuscitation (CPR) feedback devices implying better outcomes after sudden cardiac arrest. Whether effective continuous feedback could also be given verbally by a second rescuer ("human feedback") has not been investigated yet. We, therefore, compared the effect of human feedback to a CPR feedback device.
  
  
  METHODS
  In an open, prospective, randomised, controlled trial, we compared CPR performance of three groups of medical students in a two-rescuer scenario. Group "sCPR" was taught standard BLS without continuous feedback, serving as control. Group "mfCPR" was taught BLS with mechanical audio-visual feedback (HeartStart MRx with Q-CPR-Technology™). Group "hfCPR" was taught standard BLS with human feedback. Afterwards, 326 medical students performed two-rescuer BLS on a manikin for 8 min. CPR quality parameters, such as "effective compression ratio" (ECR: compressions with correct hand position, depth and complete decompression multiplied by flow-time fraction), and other compression, ventilation and time-related parameters were assessed for all groups.
  
  
  RESULTS
  ECR was comparable between the hfCPR and the mfCPR group (0.33 vs. 0.35, p = 0.435). The hfCPR group needed less time until starting chest compressions (2 vs. 8 s, p < 0.001) and showed fewer incorrect decompressions (26 vs. 33 %, p = 0.044). On the other hand, absolute hands-off time was higher in the hfCPR group (67 vs. 60 s, p = 0.021).
  
  
  CONCLUSIONS
  The quality of CPR with human feedback or by using a mechanical audio-visual feedback device was similar. Further studies should investigate whether extended human feedback training could further increase CPR quality at comparable costs for training.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Noemi
authors.initials: N
authors.lastname: Pavo
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Goliasch
authors.affiliation: Department of Anaesthesia, General Intensive Care and Pain Control, AUVA Lorenz Böhler Trauma Hospital, Vienna, Austria.
authors.forename: Franz Josef
authors.initials: FJ
authors.lastname: Nierscher
authors.affiliation: Hospital of the Sisters of Charity Linz, Linz, Austria.
authors.forename: Dominik
authors.initials: D
authors.lastname: Stumpf
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Moritz
authors.initials: M
authors.lastname: Haugk
authors.affiliation: Faculty of Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Breckwoldt
authors.affiliation: Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland.
authors.forename: Kurt
authors.initials: K
authors.lastname: Ruetzler
authors.affiliation: Department of Anaesthesiology and Pain Therapy, University Hospital Bern and University of Bern, Inselspital, 3010, Bern, Switzerland. Robert.Greif@insel.ch.
authors.forename: Robert
authors.initials: R
authors.lastname: Greif
authors.affiliation: Federal Ministry of the Interior and Sigmund Freud University Vienna, Vienna, Austria.
authors.forename: Henrik
authors.initials: H
authors.lastname: Fischer
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000295:instrumentation; D004501:Education, Medical / Q000379:methods*; D004867:Equipment Design; D005246:Feedback; D005260:Female; D005500:Follow-Up Studies; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D008297:Male; D008348:Manikins; D011312:Pressure; D011446:Prospective Studies; D013337:Students, Medical / Q000523:psychology*; D013909:Thorax; D055815:Young Adult
keywords: Basic life support (BLS); Cardiopulmonary resuscitation (CPR); Feedback device