Mobile Phone-assisted Basic Life Support Augmented with a Metronome

Paal, Peter; Pircher, Iris; Baur, Thomas; Gruber, Elisabeth; Strasak, Alexander; Herff, Holger; Brugger, Hermann; Wenzel, Volker; Mitterlechner, Thomas

doi:10.1016/j.jemermed.2011.09.011

Cited by 34 publications

(45 citation statements)

References 27 publications

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“…These better results may be explained by the metronome guidance introduced in our protocol to help in performing adequate compression rate. 32 Chest compression depth is an essential CPR quality parameter. 10,11,16,33,34 However, the recommended depth of chest compression is not achieved during manikin model simulations, even by pediatric BLS providers.…”

Section: Discussionmentioning

confidence: 99%

“…Among these, 115 met the inclusion criteria and were randomly distributed in the 4 study groups as depicted in Figure 1. According to the inclusion criteria, mean age was higher in the untrained groups (31 [24][25][26][27][28][29][30][31][32][33][34][35]years in U-NG and 27 [24-34.5]years in U-G) than in the previously trained groups (20.5 [20][21][22]years in T-NG and 21.5 [20][21][22][23][24]years in T-G), respectively (P < 0.001).…”

Section: Flow and Baseline Characteristics Of Volunteersmentioning

confidence: 96%

See 1 more Smart Citation

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Peters¹,

Stipulante²,

Delfosse³

et al. 2017

Pediatr Emer Care

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Objective: Out-of-hospital cardiac arrest (OHCA) in pediatrics is a devastating event associated with poor survival rates. Although telephone dispatcher-assisted cardiopulmonary resuscitation (CPR; T-CPR) instructions improve the frequency and quality of bystander CPR for OHCA in adults, this support remains undeveloped in children. Our objective was to assess the effectiveness of a pediatric T-CPR protocol in untrained and trained bystanders. Secondarily, we sought to determine the feasibility and the effectiveness of ventilation in such a protocol.Methods: Eligible adults with no CPR experience were recruited in a movie theater in Liege, as well as bachelor nursing students in Liege. All volunteers were randomly assigned either to T-CPR or to no-T-CPR using randomization. The volunteers were exposed to a pediatric manikin model cardiac arrest. On the basis of Cardiff evaluation test, data were collected to evaluate CPR performance.Results: A total of 115 volunteers were assigned to 4 groups: untrained nonguided group (n = 27), untrained guided group (n = 32), trained nonguided group (n = 26), and trained guided group (n = 30). We found an improvement in CPR performance in the guided groups. Most volunteers (81.2%) in untrained guided group and 83.3% in the trained guided group were able to give 2 ventilations after each compressions cycle. Conclusions:In a pediatric manikin model of OHCA, T-CPR instructions including mouth-to-mouth ventilations and chest compressions produced a significant increase in resuscitation performance not only among previously untrained but also among trained volunteers.Key Words: CPR, cardiac arrest, infant, manikin, telephone, prospective study (Pediatr Emer Care 2017;33: 00-00) A lthough uncommon in children, out-of-hospital cardiac arrest (OHCA) has devastating complications.1 Indeed, the survival rate at hospital discharge rarely exceeds 8% 2 despite care being conducted in accordance with chain of survival concept. In adults, early bystander-initiated cardiopulmonary resuscitation (CPR) has been related to better neurological outcomes and higher survival rates.4 However, regardless of population, most OHCAs still do not receive any CPR before the arrival of emergency medical services.1,5 As a consequence, only 37% of infants at best actually receive early bystander CPR, whereas most OHCAs occur at home. 3 The lack of CPR knowledge or skills has been advocated to explain this low rate of CPR and subsequent poorer prognosis for OHCA occurring in private places as compared with the ones taking place in public locations. 6,7 Besides, stress, reluctance to practice mouth-to-mouth ventilation, and fear of communicable disease are other major barriers for bystander CPR practice, although these bystanders are most frequently the parents.In adults, dispatcher-assisted compression-only CPR has been demonstrated to enhance the rate of CPR attempts. This observation was the rationale for current guidelines recommending bystander chest compression-only CPR in adults. 8 However, such recom...

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Section: Discussionmentioning

confidence: 99%

Section: Flow and Baseline Characteristics Of Volunteersmentioning

confidence: 96%

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Peters¹,

Stipulante²,

Delfosse³

et al. 2017

Pediatr Emer Care

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show abstract

“…These findings are in accordance with several adult studies showing similar results. 8,13 Our study focused on CPR with only chest compressions rather than the addition of ventilation, leading to a shorter delay to chest compressions. Initiating chest compressions early is of utmost importance, as emphasized by the changes in the traditional airway-breathing-circulation sequence to the current circulation-airway-breathing sequence put forth in the 2010 resuscitation guidelines.…”

mentioning

confidence: 99%

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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“…Improvements have also been demonstrated in studies that used a metronome, 5,6 suggesting that voice alone can provide an adequate improvement. However, although the chest compression depth slightly improved for both the cell telephone and smartphone, the compressions did not reach a sufficient depth, suggesting that this point is difficult to improve with machine guidance.…”

mentioning

confidence: 95%

Quality of Bystander Cardiopulmonary Resuscitation　– Can a Smartphone Bring About a Revolution? –

Hase

2015

Circ J

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Mobile Phone-assisted Basic Life Support Augmented with a Metronome

Cited by 34 publications

References 27 publications

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

Quality of Bystander Cardiopulmonary Resuscitation　– Can a Smartphone Bring About a Revolution? –

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Mobile Phone-assisted Basic Life Support Augmented with a Metronome

Cited by 34 publications

References 27 publications

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Using a French-Language Compression-Ventilation Pediatric Protocol

Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

Quality of Bystander Cardiopulmonary Resuscitation – Can a Smartphone Bring About a Revolution? –

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Product

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Quality of Bystander Cardiopulmonary Resuscitation　– Can a Smartphone Bring About a Revolution? –