Efficacy of metronome sound guidance via a phone speaker during dispatcher-assisted compression-only cardiopulmonary resuscitation by an untrained layperson: a randomised controlled simulation study using a manikin

Park, Sang O; Hong, Chong Kun; Shin, Dong Hyuk; Lee, Jun Ho; Hwang, Seong Youn

doi:10.1136/emermed-2012-201612

Cited by 36 publications

(45 citation statements)

References 37 publications

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“…16 There have been metronome-based studies illustrating improvement of adequate compression rate, but, unlike our study, they demonstrated a negative impact on the depth of chest compressions. 18,19 Our study focused on rate-only feedback from a metronome because it is easily accessible as part of the defibrillator machine on code carts and the defibrillators in the resuscitation room. The actual cause of suboptimal chest compression depth with metronome guidance is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been hypothesized that various factors could contribute to shallower compressions, including multitasking, rescuer fatigue, and rescuer distraction (concentrating on rate management rather than maximal effort). [18][19][20] The effect of greater compression depth is associated with increased coronary perfusion pressure, higher success of defibrillation, increased cardiac output, and improved clinical outcomes. 21,22 A compression depth of 5 cm is more effective than 4 cm in children and adults.…”

Section: Discussionmentioning

confidence: 99%

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Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

et al. 2015

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Determine whether the use of a metronome improves chest compression rate and depth during cardiopulmonary resuscitation (CPR) on a pediatric manikin.METHODS: A prospective, simulation-based, crossover, randomized controlled trial was conducted. Participants included pediatric residents, fellows, nurses, and medical students who were randomly assigned to perform chest compressions on a pediatric manikin with and without an audible metronome. Each participant performed 2 rounds of 2 minutes of chest compressions separated by a 15-minute break.RESULTS: A total of 155 participants performed 2 rounds of chest compressions (74 with the metronome on during the first round and 81 with the metronome on during the second round of CPR). There was a significant improvement in the mean percentage of compressions delivered within an adequate rate (90-100 compressions per minute) with the metronome on compared with off (72% vs 50%; mean difference [MD] 22%; 95% confidence interval [CI], 15% to 29%). No significant difference was noted in the mean percentage of compressions within acceptable depth (38-51 mm) (72% vs 70%; MD 2%; 95% CI, 22% to 6%). The metronome had a larger effect among medical students (73% vs 55%; MD 18%; 95% CI, 8% to 28%) and pediatric residents and fellows (84% vs 48%; MD 37%; 95% CI, 27% to 46%) but not among pediatric nurses (46% vs 48%; MD 23%; 95% CI, 219% to 14%). CONCLUSIONS:The rate of chest compressions during CPR can be optimized by the use of a metronome. These findings will help medical professionals comply with the American Heart Association guidelines. WHAT'S KNOWN ON THIS SUBJECT:The frequency of cardiac arrest is significantly lower in children than in adults, rendering the delivery of high-quality cardiopulmonary resuscitation more difficult. Metronome-based studies in adults showed improvement in adequate compression rate, with a detrimental effect on the depth of chest compressions. WHAT THIS STUDY ADDS:This is the first pediatric study to confirm that the use of a metronome during cardiopulmonary resuscitation significantly improves the delivery of adequate rate without affecting the compression depth. This effect was more prominent among medical students and pediatric residents and fellows than nurses. Dr Zimmerman conceptualized and designed the study, coordinated and supervised data collection, carried out the initial analysis, and drafted the initial manuscript; Dr Cohen coordinated and supervised data collection, carried out the initial analysis, and drafted the initial manuscript; Drs Maniaci, Pena, and Linares carried out initial analysis and reviewed and revised the manuscript; Dr Lozano provided statistical advice on the study design, carried out initial analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.This trial has been registered at www.clinicaltrials.gov (identifier NCT02511470). 4 Poor-quality cardiopulmonary resuscitation (CPR) has been cited as a contributing factor to this dismal statistic on outcomes. 4 Optim...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

et al. 2015

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“…One study has specifically explored this and suggested that faster rates were associated with a reduction in the quality and depth of chest compressions (Hurst et al 2011). This is backed up by some evidence of a reduction in compression depth (Oh et al 2008, Chung et al 2012, Park et al 2013. The majority of studies have been performed in simulated clinical situations using manikins.…”

Section: Commentsmentioning

confidence: 99%

BET 3: Can metronomes improve CPR quality?

Targett¹,

Harris²

2014

Emerg Med J

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A short cut review was carried out to establish whether metronomes can improve the quality of cardiopulmonary resuscitation. 38 papers were found using the reported searches, none of which directly addressed the problem but some 21 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are tabulated. It is concluded that the use of metronomes to guide the rate at which external chest compressions are delivered is associated with improved rates closer to those recommended in the current resuscitation guidelines.

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“…Among these key elements, chest compression depth was suboptimal in both groups. Most CPR simulation studies show that the quality of layperson performed chest compression rarely meets the recommended standard 12,13 , even with dispatch assistance 8, 14 . Studies showed that using simplified dispatch instruction for CPR to coach participants "push as hard as you can" could provide deeper compression when compared to standard CPR instructions, but the results of depth in these studies were still suboptimal 15 − 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Since this study was a pilot study, the sample size was set to about 30 in each group with reference to the previous studies 8, [12][13][14][15][16] .…”

Section: Statisticsmentioning

confidence: 99%

The Effect of ten-minute dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

Fukushima

Asai

Seki

et al. 2020

Preprint

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Background Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival from sudden cardiac arrest. Current CPR guidelines recommend that dispatchers assist lay rescuers performing CPR (dispatch-assisted CPR: DACPR), which can double the frequency of bystander CPR. Laypersons, however, are not familiar with receiving CPR instructions from dispatchers. DACPR training can be beneficial for lay rescuers, but this needs to be validated. The aim of this study was to determine the effectiveness of brief DACPR training for lay rescuers in addition to a standard CPR training course. Methods We conducted a randomized DACPR simulation pilot study. Participants with no CPR training within 1 year prior to this study were assigned randomly to one of two 90-minute CPR training courses (DACPR Group: a standard CPR course including DACPR training for 10 minutes or Standard Group: a standard CPR course with a simple lecture of dispatchers’ role). In the DACPR Group, participants practiced DACPR through role-playing of a dispatcher and an emergency caller. Six months after the training, the subjects in both groups performed CPR for 2 minutes under instruction by off-duty dispatchers. Results Out of the 66 participants, 59 (DACPR Group; 30, Standard Group; 29) completed the simulation. The CPR quality was similar between the two groups. However, the median time interval between call receipt and the first dispatch-assisted compression was faster in the DACPR group (108 s vs. 129 s, p = 0.042). Conclusions This brief DACPR training can be effective for lay rescuers to start chest compressions more quickly.

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Efficacy of metronome sound guidance via a phone speaker during dispatcher-assisted compression-only cardiopulmonary resuscitation by an untrained layperson: a randomised controlled simulation study using a manikin

Abstract: Metronome sound guidance during DA-COCPR for the untrained bystanders improved the chest compression rates, but was associated more with shallow compressions than the conventional DA-COCPR in a manikin model.

Cited by 36 publications

References 37 publications

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

BET 3: Can metronomes improve CPR quality?

The Effect of ten-minute dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

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