• Rasmus Meyer Lyngby, Lyra Clark, Julie Samsoee Kjoelbye, Roselil Maria Oelrich, Annemarie Silver, ChristensenHelle CollatzHCCopenhagen Emergency Medical Services, Copenhagen, Denmark., Charlotte Barfod, Freddy Lippert, Dimitra Nikoletou, Tom Quinn, and Fredrik Folke.
• Copenhagen Emergency Medical Services, Copenhagen, Denmark.
• Resusc Plus. 2021 Mar 1; 5: 100082.

ObjectivesTo investigate whether real-time ventilation feedback would improve provider adherence to ventilation guidelines.DesignNon-blinded randomised controlled simulation trial.SettingOne Emergency Medical Service trust in Copenhagen.Participants32 ambulance crews consisting of 64 on-duty basic or advanced life support paramedics from Copenhagen Emergency Medical Service.InterventionParticipant exposure to real-time ventilation feedback during simulated out-of-hospital cardiac arrest.Main Outcome MeasuresThe primary outcome was ventilation quality, defined as ventilation guideline-adherence to ventilation rate (8-10 bpm) and tidal volume (500-600 ml) delivered simultaneously.ResultsThe intervention group performed ventilations in adherence with ventilation guideline recommendations for 75.3% (Interquartile range (IQR) 66.2%-82.9%) of delivered ventilations, compared to 22.1% (IQR 0%-44.0%) provided by the control group. When controlling for participant covariates, adherence to ventilation guidelines was 44.7% higher in participants receiving ventilation feedback. Analysed separately, the intervention group performed a ventilation guideline-compliant rate in 97.4% (IQR 97.1%-100%) of delivered ventilations, versus 66.7% (IQR 40.9%-77.9%) for the control group. For tidal volume compliance, the intervention group reached 77.5% (IQR 64.9%-83.8%) of ventilations within target compared to 53.4% (IQR 8.4%-66.7%) delivered by the control group.ConclusionsReal-time ventilation feedback increased guideline compliance for both ventilation rate and tidal volume (combined and as individual parameters) in a simulated OHCA setting. Real-time feedback has the potential to improve manual ventilation quality and may allow providers to avoid harmful hyperventilation.© 2021 The Authors.

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