Successful resuscitation from cardiac arrest generally requires the early delivery of well-performed CPR. However, recent studies from our group and others have shown that the quality of CPR delivered by trained rescuers is inconsistent and often falls short of guideline recommendations. We hypothesized that CPR quality, and specifically deficiencies in chest compression and ventilation, would be improved by the use of electronic real-time feedback during resuscitative efforts. We utilized a novel investigational monitor/defibrillator equipped with both the capability to record parameters of CPR and provide relevant audiovisual feedback messages to rescuers regarding CPR deficiencies. CPR data were collected from an initial cohort of patients without feedback and subsequently from an intervention group in which feedback was enabled. We compared CPR parameters during the first 30 seconds of each resuscitation to the same parameters at 90-120 seconds. A total of 134 resuscitations were analyzed. There was a marked decrease in CPR deficiencies in feedback (n = 81), but not in control (n = 53), episodes. Resuscitations that were deficient in chest compressions (rate < 85/min) in the first 30 seconds of arrest were corrected by 90-120 seconds significantly more often when feedback was utilized (27% of baseline group corrected [15/53 to 11/53] vs 60% in feedback group [20/81 to 8/81], p = .05). Resuscitations deficient in chest compression depth (depth < 1.5 inches) were corrected more in the feedback group as well (24% of baseline group corrected (21/53 to 16/53) vs 50% in the feedback group (26/81 to 13/81), p = .07). Interestingly, resuscitations deficient in ventilation rate (rate > 20/min) did not improve with feedback (16% of baseline group corrected (32/53 to 27/53) vs 16% of feedback group (61/81 to 51/81). We conclude that real-time CPR monitoring and feedback improves chest compression quality during in-hospital cardiac arrest. Ongoing work to collect a larger feedback cohort will be required to evaluate the impact of improved CPR on clinical outcomes.
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