• Roman-Patrik Lukas, Philipp Engel, Sascha Wecker, Sebastian Thies, Hendrik Friederichs, Joachim Gerss, Hugo Van Aken, Klaus Hahnenkamp, and Andreas Bohn.
• From the Department of Anaesthesiology, Intensive Care and Pain Medicine, Münster University Hospital (RPL, PE, SW, ST, HVA, KH, AB), the Faculty of Medicine, Studienhospital Münster (HF), the Institute of Biostatistics and Clinical Research, University of Münster (JG), the City of Münster Fire Department (AB), Münster, Germany *Roman-Patrik Lukas and Philipp Engel contributed equally to the writing of the article.
• Eur J Anaesthesiol. 2013 Dec 1;30(12):752-7.

BackgroundThe 2010 Resuscitation Guidelines require high-quality chest compression and rapid defibrillation for patients with ventricular fibrillation with rhythm analysis and defibrillation repeated every 2 min. A lack of adherence to the guidelines by medical students was observed during simulated resuscitation training.ObjectivesTo assess whether real-time cardiopulmonary resuscitation guidance, including an audiovisual countdown timer, a metronome, a display of the chest compression quality and voice prompts, might improve adherence to the guidelines by medical students.DesignRandomised cross-over simulation study.SettingStudienhospital Münster, Faculty of Medicine University Münster, GermanyParticipantsOne hundred and forty-one medical students (fifth year) in 47 teams.InterventionSimulated resuscitation with and without real-time cardiopulmonary resuscitation guidance.Main Outcome MeasuresThe preshock pause, postshock pause, fraction of time without chest compression and defibrillation intervals. Observed quality parameters were chest compression depth and chest compression rate.ResultsWith real-time cardiopulmonary resuscitation guidance, there were improved mean (SD) chest compression rates (105 ± 8 vs. 121 ± 12 bpm; P < 0.005), fewer inappropriate shock intervals [median (interquartile range) 0 (1 to 5) vs. 4 (1 to 7); P < 0.005], a smaller fraction of time without chest compression (18.9 ± 4.4 vs. 22.5 ± 7.0%; P < 0.005) and shorter postshock pauses (2.3 ± 0.9 vs. 3.4 ± 1.2 s; P < 0.005).ConclusionReal-time cardiopulmonary resuscitation guidance significantly increased adherence to the guidelines by medical students treating simulated out-of-hospital cardiac arrest. Using a simple tool such as a countdown timer makes it possible to reduce the number of inappropriate shock intervals and time without chest compression.

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