• Arch. Dis. Child. · May 2017

    Randomized Controlled Trial

    Randomised crossover trial of rate feedback and force during chest compressions for paediatric cardiopulmonary resuscitation.

    • Rachael Kathleen Gregson, Tim James Cole, Sophie Skellett, Emmanouil Bagkeris, Denise Welsby, and Mark John Peters.
    • UCL Great Ormond Street Institute of Child Health, London, UK.
    • Arch. Dis. Child. 2017 May 1; 102 (5): 403-409.

    ObjectiveTo determine the effect of visual feedback on rate of chest compressions, secondarily relating the forces used.DesignRandomised crossover trial.SettingTertiary teaching hospital.SubjectsFifty trained hospital staff.InterventionsA thin sensor-mat placed over the manikin's chest measured rate and force. Rescuers applied compressions to the same paediatric manikin for two sessions. During one session they received visual feedback comparing their real-time rate with published guidelines.Outcome MeasuresPrimary: compression rate. Secondary: compression and residual forces.ResultsRate of chest compressions (compressions per minute (compressions per minute; cpm)) varied widely (mean (SD) 111 (13), range 89-168), with a fourfold difference in variation during session 1 between those receiving and not receiving feedback (108 (5) vs 120 (20)). The interaction of session by feedback order was highly significant, indicating that this difference in mean rate between sessions was 14 cpm less (95% CI -22 to -5, p=0.002) in those given feedback first compared with those given it second. Compression force (N) varied widely (mean (SD) 306 (94); range 142-769). Those receiving feedback second (as opposed to first) used significantly lower force (adjusted mean difference -80 (95% CI -128 to -32), p=0.002). Mean residual force (18 N, SD 12, range 0-49) was unaffected by the intervention.ConclusionsWhile visual feedback restricted excessive compression rates to within the prescribed range, applied force remained widely variable. The forces required may differ with growth, but such variation treating one manikin is alarming. Feedback technologies additionally measuring force (effort) could help to standardise and define effective treatments throughout childhood.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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