scholarly journals Real-time feedback systems for cardiopulmonary resuscitation training: time for a paradigm shift

2018 ◽  
Vol 10 (2) ◽  
pp. E162-E163 ◽  
Author(s):  
Andrea Cortegiani ◽  
Enrico Baldi ◽  
Pasquale Iozzo ◽  
Filippo Vitale ◽  
Santi Maurizio Raineri ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Paradigm Shift ◽  
Feedback Systems ◽  
Training Time ◽  
Resuscitation Training

scholarly journals Effect of real-time feedback during cardiopulmonary resuscitation training on quality of performances: A prospective cluster-randomized trial

2019 ◽  
Vol 27 (4) ◽  
pp. 187-196
Author(s):  
So Yeon Joyce Kong ◽  
Kyoung Jun Song ◽  
Sang Do Shin ◽  
Young Sun Ro ◽  
Helge Myklebust ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Randomized Trial ◽  
Real Time ◽  
Cluster Randomized Trial ◽  
Group Model ◽  
Feedback Group ◽  
Resuscitation Training ◽  
Objective Feedback ◽  
Cluster Randomized

Background: The evidence supporting delivery of quality cardiopulmonary resuscitation is growing and significant attention has been focused on improving bystander cardiopulmonary resuscitation education for laypeople. The aim of this randomized trial was to assess the effectiveness of instructor’s real-time objective feedback during cardiopulmonary resuscitation training compared to conventional feedback in terms of trainee’s cardiopulmonary resuscitation quality. Methods: We performed a cluster-randomized trial of community cardiopulmonary resuscitation training classes at Nowon District Health Community Center in Seoul. Cardiopulmonary resuscitation training classes were randomized into either intervention (instructor’s objective real-time feedback based on the QCPR Classroom device) or control (conventional, instructor’s judgment-based feedback) group. The primary outcome was total cardiopulmonary resuscitation score, which is an overall measure of chest compression quality. Secondary outcomes were individual cardiopulmonary resuscitation performance parameters, including compression rate, depth, and release. Generalized linear mixed models were used to analyze the outcome data, accounting for both random and fixed effects. Results: A total of 149 training sessions (2613 trainees) were randomized into 70 intervention (1262 trainees) and 79 control (1351 trainees) groups. Trainees in the QCPR feedback group significantly increased overall cardiopulmonary resuscitation score performance compared with those in the conventional feedback group (model-based mean Δ increment from baseline to session 5: 11.2 (95% confidence interval 9.2–13.2) and 8.0 (6.0–9.9), respectively; p = 0.02). Individual parameters of compression depth and release also showed higher improvement among trainees in QCPR group with positive trends (p < 0.08 for both). Conclusion: This randomized trial suggests beneficial effect of instructor’s real-time objective feedback on the quality of layperson’s cardiopulmonary resuscitation performance.

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

2020 ◽  
pp. bmjstel-2020-000709
Author(s):  
Yiqun Lin ◽  
Kent Hecker ◽  
Adam Cheng ◽  
Vincent J Grant ◽  
Gillian Currie
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Care Providers ◽  
Training Time ◽  
Distributed Training ◽  
Cpr Quality ◽  
The Cost ◽  
Cpr Training

ContextAlthough distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR training.MethodsWe measured educational resource use, costs, and outcomes of both conventional training and distributed training groups in a prospective-randomised trial conducted with paediatric acute care providers over 12 months. Costs were calculated and reported from the perspective of the health institution. Incremental costs and effectiveness of distributed CPR training relative to conventional training were presented. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) if appropriate. One-way sensitivity analyses and probabilistic sensitivity analysis were conducted.ResultsA total of 87 of 101 enrolled participants completed the training (46/53 in intervention and 41/48 in the control). Compared with conventional training, the distributed CPR training group had a higher proportion of participants achieving CPR excellence, defined as over 90% guideline compliant for chest compression depth, rate and recoil (control: 0.146 (6/41) vs intervention 0.543 (25/46), incremental effectiveness: +0.397) with decreased costs (control: $C266.50 vs intervention $C224.88 per trainee, incremental costs: −$C41.62). The sensitivity analysis showed that when the institution does not pay for the training time, distributed CPR training results in an ICER of $C147.05 per extra excellent CPR provider.ConclusionWorkplace-based distributed CPR training with real-time feedback resulted in improved CPR quality by paediatric healthcare providers and decreased training costs, when training time is paid by the institution. If the institution does not pay for training time, implementing distributed training resulted in better CPR quality and increased costs, compared with conventional training. These findings contribute further evidence to the decision-making processes as to whether institutions/programmes should financially adopt these training programmes.

Abstract 275: Automated External Defibrillator with Real-Time Audiovisual Feedback System Improves the Quality of Cardiopulmonary Resuscitation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kenji Hayashi ◽  
Hiroaki Ushikoshi ◽  
Naoki Matsumaru ◽  
Sho Nachi ◽  
Hikaru Nachi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Healthcare Professionals ◽  
Feedback System ◽  
Automated External Defibrillator ◽  
Feedback Systems ◽  
External Defibrillator

Background: Public access defibrillation (PAD) with automated external defibrillator (AED) is a widely available and beneficial intervention for cardiac arrest. The quality of chest compressions (CC) is an important determinant of the outcome of cardiopulmonary resuscitation (CPR). In Japan, AED with real-time audiovisual feedback is being implemented, and has been available to bystanders since 2011. However, the benefit of CC feedback systems for laypersons remains unclear. In this study, we sought to determine the effects of audiovisual feedback system on the quality of CC in bystanders with different medical backgrounds. Methods: A total of 478 individuals (151 healthcare professionals [mean age, 31.3 years], 76 medical students [mean age, 23.6 years], and 251 non-healthcare professionals [mean age, 40.1 years]) participated in a CPR quality improvement challenge. Participants performed two 2-min trials of CC on a training manikin equipped with an accelerometer-based system for measuring both rate and depth of CC. Real-time audiovisual feedback was disabled during first trial, but activated during the second trial. The quality of CC was evaluated by counting the number of compressions with the appropriate depth (5.0-10 cm) and rate (100-120 cpm) in each trial. Results: Among all participants, mean depth of CC was higher (6.35 vs. 5.87 cm), and mean rate was lower (102.4 vs. 112.2 cpm) when the feedback system was activated than when it was disabled (p < 0.05). When real-time feedback was activated, non-healthcare professional participants performed CC of greater depth (6.41 vs. 5.63 cm) than healthcare professionals (6.25 vs. 6.09 cm) and medical students (6.34 vs. 6.19 cm) (p < 0.05). The quality index of CC, which the percentage of adequate depth and rate, was also significantly improved regardless medical backgrounds (p < 0.05). Conclusions: The use of real-time CPR feedback systems improves the quality of CC performed by individuals of all backgrounds, especially non-healthcare personnel. PAD with AED providing CPR feedback technologies may elevate the survival rate of out-of-hospital cardiac arrest and increase the likelihood of favorable outcomes.

scholarly journals A Sensor for Spirometric Feedback in Ventilation Maneuvers during Cardiopulmonary Resuscitation Training

Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5095 ◽  
Author(s):  
Rodolfo Rocha Vieira Leocádio ◽  
Alan Kardek Rêgo Segundo ◽  
Cibelle Ferreira Louzada
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Forced Expiratory Volume ◽  
Human Respiration ◽  
Resuscitation Training ◽  
Measurement Results ◽  
Forced Expiratory Flow ◽  
Minimum Requirements ◽  
Ventilation Performance ◽  
Cpr Training

This work proposes adapting an existing sensor and embedding it on mannequins used in cardiopulmonary resuscitation (CPR) training to accurately measure the amount of air supplied to the lungs during ventilation. Mathematical modeling, calibration, and validation of the sensor along with metrology, statistical inference, and spirometry techniques were used as a base for aquiring scientific knowledge of the system. The system directly measures the variable of interest (air volume) and refers to spirometric techniques in the elaboration of its model. This improves the realism of the dummies during the CPR training, because it estimates, in real-time, not only the volume of air entering in the lungs but also the Forced Vital Capacity (FVC), Forced Expiratory Volume (FEVt) and Medium Forced Expiratory Flow (FEF20–75%). The validation of the sensor achieved results that address the requirements for this application, that is, the error below 3.4% of full scale. During the spirometric tests, the system presented the measurement results of (305 ± 22, 450 ± 23, 603 ± 24, 751 ± 26, 922 ± 27, 1021 ± 30, 1182 ± 33, 1326 ± 36, 1476 ± 37, 1618 ± 45 and 1786 ± 56) × 10−6 m3 for reference values of (300, 450, 600, 750, 900, 1050, 1200, 1350, 1500, 1650 and 1800) × 10−6 m3, respectively. Therefore, considering the spirometry and pressure boundary conditions of the manikin lungs, the system achieves the objective of simulating valid spirometric data for debriefings, that is, there is an agreement between the measurement results when compared to the signal generated by a commercial spirometer (Koko brand). The main advantages that this work presents in relation to the sensors commonly used for this purpose are: (i) the reduced cost, which makes it possible, for the first time, to use a respiratory volume sensor in medical simulators or training dummies; (ii) the direct measurement of air entering the lung using a noninvasive method, which makes it possible to use spirometry parameters to characterize simulated human respiration during the CPR training; and (iii) the measurement of spirometric parameters (FVC, FEVt, and FEF20–75%), in real-time, during the CPR training, to achieve optimal ventilation performance. Therefore, the system developed in this work addresses the minimum requirements for the practice of ventilation in the CPR maneuvers and has great potential in several future applications.

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