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Device-led versus human-led feedback on chest compressions for cardiopulmonary resuscitation and providers’ experience and preference: a randomised crossover study
medRxiv - Emergency Medicine Pub Date : 2022-09-27 , DOI: 10.1101/2022.09.25.22280283
Muhaimin Noor Azhar , Aida Bustam , Khadijah Poh , Keng Sheng Chew , Asraff Azman , Anhar Kamarudin , Aliyah Zambri

Background: High cardiopulmonary resuscitation (CPR) quality is associated with better patient survival from cardiac arrest. However, CPR providers may not have an accurate perception of the depth and rate of their chest compressions (CC). Realtime feedback during resuscitation improves CPR quality compared to no feedback. Evidence comparing audio-visual feedback device (AVF) and team leader’s feedback (TLF) in improving CPR performance is limited and conflicting. Methodology: We performed a randomized crossover study to evaluate CC performance with AVF and TLF. Seventy participants performed CC for 1 minute on a CPR manikin connected to ZOLL R series defibrillator with CPR-sensing capability in a randomised crossover sequence. We interviewed participants to explore their perception and preference with both feedback methods. Results: Mean CC rate was higher with AVF than with TLF (121.8 min -1 ± 17.7 vs. 117.4 min -1 ± 13.5, p = 0.005). There was no significant difference in proportions of participants performing CC within the recommended rate of 100-120 beats per minute between AVF and TLF (48.6% and 51.4%, p = 0.824). Overall, CC depth was below the recommended target regardless of feedback method with mean CC depth of 4.4 cm ± 0.8 in AVF and 4.3 cm ± 0.9 in TLF respectively ( p = 0.479). Most participants felt that TLF was easier to follow, more motivating and preferable compared to AVF. Those who preferred TLF performed CC at rates above the recommended range with AVF compared to TLF (124.1 min -1 ± 19.4 versus 118.2 min -1 ± 14.9, p = 0.004). Conclusion: A well-trained team leader is as effective as an AVF device in leading high-quality CC. CPR providers’ performance may be influenced by their preferred feedback method.

中文翻译:

设备主导与人工主导的心肺复苏胸外按压反馈以及提供者的经验和偏好:一项随机交叉研究

背景:高心肺复苏 (CPR) 质量与更好的心脏骤停患者存活率相关。然而,CPR 提供者可能无法准确了解他们的胸部按压 (CC) 的深度和频率。与没有反馈相比,复苏期间的实时反馈提高了 CPR 质量。比较视听反馈设备 (AVF) 和团队负责人反馈 (TLF) 在提高 CPR 性能方面的证据有限且相互矛盾。方法:我们进行了一项随机交叉研究,以评估 AVF 和 TLF 的 CC 性能。70 名参与者在 CPR 模型上执行了 1 分钟的 CC,该模型连接到具有 CPR 感应能力的 ZOLL R 系列除颤器,以随机交叉序列进行。我们采访了参与者,以探索他们对两种反馈方法的看法和偏好。结果:AVF 的平均 CC 率高于 TLF(121.8 min -1 ± 17.7 vs. 117.4 min -1 ± 13.5,p = 0.005)。在 AVF 和 TLF 之间,在推荐的 100-120 次/分钟的心率范围内进行 CC 的参与者比例没有显着差异(48.6% 和 51.4%,p = 0.824)。总体而言,无论采用何种反馈方法,CC 深度均低于推荐目标,平均 CC 深度分别为 4.4 cm ± 0.8 in AVF 和 4.3 cm ± 0.9 in TLF (p = 0.479)。大多数参与者认为与 AVF 相比,TLF 更容易遵循、更有动力且更可取。与 TLF 相比,那些更喜欢 TLF 的人使用 AVF 以高于推荐范围的速率执行 CC(124.1 分钟 -1 ± 19.4 对 118.2 分钟 -1 ± 14.9,p = 0.004)。结论:训练有素的团队领导者在领导高质量 CC 方面与 AVF 设备一样有效。
更新日期:2022-09-28
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