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Simul Healthc. 2014 Aug;9(4):264-9. doi: 10.1097/SIH.0000000000000030.

Immediate and 1-year chest compression quality: effect of instantaneous feedback in simulated cardiac arrest.

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From the College of Medicine (P.G., J.G.), Penn State University, Hershey; and Juniata College (C.C.), Huntingdon, PA; and Department of Emergency Medicine (T.E.T.), Ohio State University, Columbus, OH.



Several studies have demonstrated subpar chest compression (CC) performance by trained health care professionals. The objective of this study was to determine the immediate and sustained effect of instantaneous audiovisual feedback on CC quality.


A prospective, randomized, crossover study measuring the effect of audiovisual feedback training on the performance of CCs by health care providers and medical students in a simulated cardiopulmonary arrest scenario was performed. Compression rate, hand placement, depth, and recoil were collected using 60-second epochs of CC on a simulation mannequin.


Data from 200 initial enrollments and 100 tested 1 year later were analyzed by evaluators using standard criterion. At initial testing, feedback trainees demonstrated significantly improved depth compliance, recoil compliance, and accuracy of hand placement. One year later, the previous year's control group now receiving feedback demonstrated immediate improvement in depth, hand placement, and rate. In the feedback group, the only statistically significant improvement from initial baseline to the baseline 1 year later was an 18% improvement in depth compliance. However, the same improvement rate was seen in the control group. Improved depth compliance performance was correlated to the number of cardiopulmonary resuscitation training sessions received external to the study.


Instantaneous audiovisual feedback training on CC quality produces immediate improvements in compression rate, hand placement, as well as depth and recoil compliance. These improvements, however, are not retained 1 year later. Improved depth performance may be correlated to an increased training frequency.

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