Biomedical Engineering Research Group, Cardiff University, Cardiff, UK.
Paediatric Emergency Department, Imperial College Hospital NHS Healthcare Trust, London, UK.
Arch Dis Child. 2019 Aug;104(8):793-801. doi: 10.1136/archdischild-2018-316576. Epub 2019 Jun 4.
Performing high-quality chest compressions during cardiopulmonary resuscitation (CPR) requires achieving of a target depth, release force, rate and duty cycle.
This study evaluates whether 'real time' feedback could improve infant CPR performance in basic life support-trained (BLS) and lay rescuers. It also investigates whether delivering rescue breaths hinders performing high-quality chest compressions. Also, this study reports raw data from the two methods used to calculate duty cycle performance.
BLS (n=28) and lay (n=38) rescuers were randomly allocated to respective 'feedback' or 'no-feedback' groups, to perform two-thumb chest compressions on an instrumented infant manikin. Chest compression performance was then investigated across three compression algorithms (compression only; five rescue breaths then compression only; five rescue breaths then 15:2 compressions). Two different routes to calculate duty cycle were also investigated, due to conflicting instruction in the literature.
No-feedback BLS and lay groups demonstrated <3% compliance against each performance target. The feedback rescuers produced 20-fold and 10-fold increases in BLS and lay cohorts, respectively, achieving all targets concurrently in >60% and >25% of all chest compressions, across all three algorithms. Performing rescue breaths did not impede chest compression quality.
A feedback system has great potential to improve infant CPR performance, especially in cohorts that have an underlying understanding of the technique. The addition of rescue breaths-a potential distraction-did not negatively influence chest compression quality. Duty cycle performance depended on the calculation method, meaning there is an urgent requirement to agree a single measure.
在心肺复苏（CPR）期间进行高质量的胸外按压需要达到目标深度、释放力、速率和工作周期。
本研究评估实时反馈是否可以提高基础生命支持（BLS）培训的和非专业救援人员对婴儿 CPR 的性能。它还调查了是否进行人工呼吸会妨碍高质量的胸外按压。此外，本研究报告了用于计算工作周期性能的两种方法的原始数据。
BLS（n=28）和非专业（n=38）救援人员被随机分配到各自的“反馈”或“无反馈”组，在仪器化婴儿模型上进行两指胸外按压。然后，在三种压缩算法（仅压缩；五次人工呼吸后仅压缩；五次人工呼吸后 15:2 压缩）下对胸外按压性能进行了调查。由于文献中存在相互矛盾的说明，还研究了两种不同的计算工作周期的方法。
无反馈 BLS 和非专业组对每个性能目标的合规性均<3%。反馈救援人员使 BLS 和非专业组的比例分别增加了 20 倍和 10 倍，在所有三种算法中，超过 60%和 25%的所有胸外按压都同时达到了所有目标。进行人工呼吸不会影响胸外按压的质量。
反馈系统具有很大的潜力来提高婴儿 CPR 的性能，特别是在对技术有基本了解的人群中。添加人工呼吸-这可能是一种干扰-不会对胸外按压质量产生负面影响。工作周期性能取决于计算方法，这意味着迫切需要达成一个单一的衡量标准。
