Metronome use improves achievement of a target compression rate in out-of-hospital cardiac arrest: A retrospective analysis
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Updated: Jul 24, 2025
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Published on: January 30, 2020
Jacob Kennedy1, Kimberly Machado2, Charles Maynard3
1School of Medicine, University of Washington, United States.
Aim:
The aim of this study was to evaluate chest compression rates (CCR) with and without the use of a metronome during treatment of out-of-hospital cardiac arrest (OHCA).
Methods:
We performed a retrospective cohort investigation of non-traumatic OHCA cases treated by Seattle Fire Department from January 1, 2013, to December 31, 2019. The exposure was a metronome running during CPR at a rate of 110 beats per minute. The primary outcome was the median CCR for all periods of CPR with a metronome compared to periods without a metronome.
Results:
We included 2,132 OHCA cases with 32,776 minutes of CPR data; 15,667 (48%) minutes had no metronome use, and 17,109 (52%) minutes had a metronome used. Without a metronome, the median CCR was 112.8 per minute with an interquartile range of 108.4 - 119.1, and 27% of minutes were above 120 or less than 100. With a metronome, the median CCR was 110.5 per minute with an interquartile range of 110.0-112.0, and less than 4% of minutes were above 120 or less than 100. The compression rate was 109, 110, or 111 in 62% of minutes with a metronome compared to 18% of minutes with no metronome.
Conclusion:
The use of a metronome during CPR resulted in increased compliance to a predetermined compression rate. Metronomes are a simple tool that improves achievement of a target compression rate with little variance from that target.
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