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Effect of caregiver gender, age, and feedback prompts on chest compression rate and depth
Mary Ann Peberdy1, Annemarie Silver, Joseph P Ornato
1Virginia Commonwealth University, Richmond, VA 23298, United States. mpeberdy@aol.com
Background:
Quality of chest compressions (CC) is an important determinant of resuscitation outcome for cardiac arrest patients.
Purpose:
To characterize the quality of CC performed by hospital personnel, evaluate for predictors of CC performance, and determine the effects of audiovisual feedback on CC performance.
Methods:
Seven hundred and fifty four individuals participated in a CPR quality improvement challenge at 30 US hospitals. Participants performed 2min of CC on a manikin with an accelerometer-based system for measuring both rate (CC/min) and depth (in.) of CC (AED Plus:ZOLL Medical). Real-time audiovisual feedback was disabled. A subset of participants performed a second trial of CC with the audiovisual feedback prompts activated.
Results:
Mean depth of CC was below AHA minimum guidelines (<1.5in.) for 34% (1.30+/-0.14in.) and above maximum guidelines (>2.0in.) for 12% of participants (2.20+/-0.22in.). Depth of CC was greater for male vs. female (p<0.001) and younger vs. older (p=0.009) but did not differ between ACLS, BCLS, and non-certified participants (p=0.6). Predictors of CC depth included CC rate (r(part)=-0.34, p<0.0001), gender (r(part)=0.13, p=0.001), and age (r(part)=-0.09, p=0.02). Mean depth of CC increased, mean rate decreased, and variance in CC depth and rate declined when feedback was used (p< or =0.0001 vs. without feedback). The percentage of CC performed within AHA guidelines (1.5-2in.) improved from 15 to 78% with feedback.
Conclusions:
The quality of CC performed by personnel at US hospitals as judged by their performance on a manikin is often suboptimal. Quality of CC can be improved with use of CPR feedback technologies.
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