The Use of Automated Real-Time Feedback Devices to Improve Quality During CPR Training and Real CPR Performance: A Systematic Review

Abstract

High quality cardiopulmonary resuscitation (CPR) is imperative to improve patient outcome after a cardiac arrest. However, it has been demonstrated that CPR quality is normally of suboptimal quality in both real-life resuscitation attempts or simulated training. Automated real-time feedback (ARTF) devices have been considered a potential tool to improve the quality of CPR and maximise retention of the skills. Although previous studies have supported the usefulness of such devices during training, others have conflicting conclusions with regards to its efficacy during real-life CPR. This systematic review of the literature aims to assess the effectiveness of ARTF for improving CPR performance during simulated training and real-life resuscitation in the adult and paediatric population. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines [1], articles published between January 2010 and November 2019 were searched from 7 electronic databases (SCIELO, LILACS, BVS, PubMed, Web of Science, Embase, Cochrane, Cinahl, Google Scholar) and reviewed according to the pre-defined eligibility criteria. CPR performance quality was assessed based on guideline compliance for chest compression rate, chest compression depth and complete chest recoil. 871 studies were found, and 32 studies met inclusion criteria. 14 randomised controlled trials (RCTs), 08 randomised trials (RTs) and 10 randomised cross-over trials (RCOTs). Each study used ARTF devices during CPR training or real CPR to analyse the performance of healthcare professionals for paediatric or adult population. According to the studies, the use of ARTF devices enhances CPR performance in terms of achieving the recommended chest compression rate, depth and recoil. Based on the results of the studies analysed in this review, the use of ARTF can significantly help improve CPR performance during training of healthcare professionals. Further research is needed to reach the same conclusion for real-life CPR.