Training CPR with a wearable real time feedback system (original) (raw)
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Real-Time Audiovisual Feedback Training Improves Cardiopulmonary Resuscitation Performance
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2019
The aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance. Methods: This is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One class (control group) was taught using manikin-based standard CPR education models. The second class (intervention group) was taught similarly, but with the addition of real-time CPR quality feedback provided by the manikins. Students' performance was assessed using a standardized Objective Structured Clinical Examination scenario, during which no real-time feedback was provided. Critical CPR parameters were measured including compression depth, chest recoil, ventilation volume, and "hands-off" time. Results: A total of 201 participants were included in the study, 106 in the control group and 95 in the intervention group. Baseline demographic characteristics and previous medical knowledge were similar for the 2 groups. A significant improvement was observed for all primary study outcomes in favor of the real-time feedback group for median (interquartile range) chest compression fraction [57 (52.75%-60%) vs. 49 (43%-55%), P < 0.001], compressions with adequate depth [66.5 (19.5%-95.25%) vs. 0 (0%-12%), P < 0.001], ventilations with adequate volume [68.5 (33%-89%) vs. 37 (0%-70%), P < 0.00], and a simulator-derived composite "total CPR score" [39 (24%-61.25%) vs. 13 (3.5%-22%), P < 0.001]. In multiple regression analysis, the real-time feedback group's performance was significantly better than the control group in all primary outcomes, adjusting for participant's characteristics of age, sex, and body mass index. Conclusions: The use of audiovisual feedback techniques to teach CPR improves skill acquisition with significant improvement in crucial prognosis-improving parameters, as tested in a "no-feedback" test scenario.
CJEM, 2017
Objective The chances of surviving an out-of-hospital cardiac arrest depend on early and high-quality cardiopulmonary resuscitation (CPR). Our aim is to verify whether the use of feedback devices during laypersons’ CPR training improves chest compression quality. Methods Laypersons totalling 450 participating in Basic Life Support and Automated External Defibrillation (BLS/AED) courses were randomly divided into three groups: group No Feedback (NF) attended a course without any feedback, group Short Feedback (SF) a course with 1-minute training with real-time visual feedback, and group Long Feedback (LF) a course with 10-minute training with real-time visual feedback. At the end of each course, we recorded 1 minute of compression-only CPR. The primary end point was the difference in the percentage of compressions performed with correct depth. Results There was a significant improvement in the percentage of compressions with correct depth in the groups receiving feedback compared to ...
Physiological Measurement, 2011
This study aims to contribute to the scarce data available about the abilities of untrained lay persons to perform hands-only cardio-pulmonary resuscitation (CPR) on a manikin and the improvement of their skills during training with an autonomous CPR feedback device. The study focuses on the following questions: (i) Is there a need for such a CPR training device? (ii) How adequate are the embedded visual feedback and audio guidance for training of lay persons who learn and correct themselves in real time without instructor guidance? (iii) What is the achieved effect of only 3 min of training? This is a prospective study in which 63 lay persons (volunteers) received a debriefing to basic life support and then performed two consecutive 3 min trials of hands-only CPR on a manikin. The pre-training skills of the lay persons were tested in trial 1. The training process with audio guidance and visual feedback from a cardio compression control device (CC-Device) was recorded in trial 2. After initial debriefing for correct chest compressions (CC) with rate 85-115 min-1, depth 3.8-5.4 cm and complete recoil, in trial 1 the lay persons were able to perform CC without feedback at mean rate 95.9 ± 18.9 min-1, mean depth 4.13 ± 1.5 cm, with low proportions of 'correct depth', 'correct rate' and 'correct recoil' at 33%, 43%, 87%, resulting in the scarce proportion of 14% for compressions, which simultaneously fulfill the three quality criteria ('correct all'). In trial 2, the training process by the CC-Device was established by the significant improvement of the CC skills until the 60th second of training, when 'correct depth', 'correct rate' and 'correct recoil' attained the plateau of the highest quality at 82%, 90%, 96%, respectively, resulting in 73% 'correct all' compressions within 3 min of training. The training was associated with reduced variance of the mean rate 102.4 ± 4.7 min-1 and mean depth 4.3 ± 0.4 cm, indicating a steady CC performance achieved among all trained participants. Multivariable linear regression showed that the compression depth, rate and complete chest recoil did not strongly depend on lay person age, gender, height, weight in pre-training and training stage (correlation coefficient below 0.54). The study confirmed the need for developing CPR abilities in untrained lay persons via training by real-time feedback from the instructor or CC-Device. The CC-Device embedded feedback was shown to be comprehensible and easy to be followed and interpreted. The high quality of the CC-Device-assisted training process of lay persons was confirmed. Thus learning or refresher courses in basic life support could be organized for more people trained at the same time with fewer instructors needed only for the initial debriefing and presentation of the CC-Device.
HOSPITALS. The chances for patient survival are improved with immediate and high quality CPR (Abella,). However, any given nurse in day-today practice settings may use CPR skills infrequently. Nursing students are expected to have an understanding of CPR and the ability to perform the basic skills, completing a course prior to entering the nursing program or beginning their clinical practice. At this time, there is limited research on nursing students' ability to perform CPR. However, studies suggest that skills developed from a CPR course are lost quickly when they are not practiced. In a quasi-experimental study, Madden (2006) examined the retention of CPR skills of 55 nursing students in Ireland. While students acquired CPR knowledge and skills immediately following their instructor-led (IL) course, there was a significant deterioration of skills at the 10-week posttest. An important finding was that even though students learned about CPR and could demonstrate the skills, they could not pass the CPR skill assessment at any time in the study. Kardong-Edgren and Adamson (2009) assessed videotapes of students performing CPR as part of a simulation 22 weeks after passing a CPR course. None of the students could perform the key components of CPR correctly. The lack of retention of CPR skills among nursing students is consistent with findings of studies with other health care providers and lay rescuers: CPR skill deteriorates more rapidly than does CPR knowledge) proposed a number of variables that can affect skill retention, including insufficient practice, too much time between the course and actual practice, lack of supervision and feedback during learning, lack of consistency in and quality of the teaching of CPR, and the complexity of the skill being taught. Instructor-led CPR courses have several potential limitations. The pace of the course is preset, which does not allow adaptation to individual learning needs of students, particularly with regard to providing enough practice time. While instructors are certified, they may not accurately assess performance or correct errors. In a study by Lynch, Einspruch, Nichol, and Aufderheide (2008), 826 lay persons were trained in CPR, followed by an assessment of five CPR skills by 13 AHA-certified instructors. CPR skills also were assessed using sensorized Resusci Anne TM manikins with Laerdal PC SkillReporting™ software. Instructors were able to accurately rate participants' ventilation skills but not their chest compressions or hand placement. Several innovative methods, such as video self-instruction, have been developed to improve CPR training (Batcheller, Brennan, Braslow,. In a study by Batcheller et al., 202 lay persons were randomly assigned to either IL training or video self-instruction. Learning was assessed immediately following the training using a Laerdal-Skillmeter™ manikin. Individuals who completed the video self-instruction performed correctly 20.8 percent of compressions and 25.1 percent of ventilations, compared with 3.4 percent of compressions and 1.7 percent of ventilations in the IL group. Overall performance was also better in the video group, leading the researchers to conclude that video self-instruction was an effective and convenient method for CPR training. In another study, retention of CPR skill was no different following A A B S T R A C T The purpose of this study was to evaluate the effectiveness of HeartCode TM BLS, a self-directed, computer-based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopul-monary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor-led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReporting ™ System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who had the standard, IL course with regular manikins.
2020
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 ...
Importance of Immediate Electronic-Based Feedback to Enhance Feedback for First-Time CPR Trainees
International Journal of Environmental Research and Public Health
Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the par...
A novel CPR training method using a smartphone app
Journal of Acute Disease, 2016
The study aims to validate that a smartphone application can assist in the learning and skills retention for cardiopulmonary resuscitation training. This cardiopulmonary resuscitation feature of the Crowdsav platform is designed to record the chest compression performance as well as the rate of compressions of the trainee. Crowdsav is available for downloading in the public domain. The application, once downloaded can be utilised during training and be replayed by the trainee at his/her own will or via reminders from the training centre. The goal of using this application is to minimise the decay of the knowledge and compression skills and perhaps even reduce the resource for recertification, as skills and performance can be kept up, maintained and monitored remotely by a training centre using the application.
Effect of Using an Audiovisual CPR Feedback Device on Chest Compression Rate and Depth
Annals of the Academy of Medicine, Singapore
Introduction: The aim of the study is to investigate the effect of using Automated External Defibrillator (AED) audiovisual feedback on the quality of cardiopulmonary resuscitation (CPR) in a manikin training setting. Materials and Methods: Five cycles of 30 chest compressions were performed on a manikin without CPR prompts. After an interval of at least 5 minutes, the participants performed another 5 cycles with the use of real time audiovisual feedback via the ZOLL E-Series defibrillator. Performance data were obtained and analysed. Results: A total of 209 dialysis centre staff participated in the study. Using a feedback system resulted in a statistically significant improvement from 39.57% to 46.94% (P = 0.009) of the participants being within the target compression depth of 4 cm to 5 cm and a reduction in those below target from 16.45% to 11.05% (P= 0.004). The use of feedback also produced a significant improvement in achieving the target for rate of chest compression (90 to 11...
Do automated real-time feedback devices improve CPR quality? A systematic review of literature
Resuscitation Plus, 2021
Aim: Automated real-time feedback devices have been considered a potential tool to improve the quality of cardiopulmonary resuscitation (CPR). Despite previous studies supporting the usefulness of such devices during training, others have conflicting conclusions regarding its efficacy during reallife CPR. This systematic review aimed to assess the effectiveness of automated real-time feedback devices for improving CPR performance during training, simulation and real-life resuscitation attempts in the adult and paediatric population. Methods: Articles published between January 2010 and November 2020 were searched from BVS, Cinahl, Cochrane, PubMed and Web of Science, and reviewed according to a pre-defined set of eligibility criteria which included healthcare providers and randomised controlled trial studies. CPR quality was assessed based on guideline compliance for chest compression rate, chest compression depth and residual leaning. Results: The selection strategy led to 19 eligible studies, 16 in training/simulation and three in real-life CPR. Feedback devices during training and/or simulation resulted in improved acquisition of skills and enhanced performance in 15 studies. One study resulted in no significant improvement. During real resuscitation attempts, three studies demonstrated significant improvement with the use of feedback devices in comparison with standard CPR (without feedback device). Conclusion: The use of automated real-time feedback devices enhances skill acquisition and CPR performance during training of healthcare professionals. Further research is needed to better understand the role of feedback devices in clinical setting.