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West J Emerg Med. 2014 Jul;15(4):404-8. doi: 10.5811/westjem.2014.1.19636.

Effect of prior cardiopulmonary resuscitation knowledge on compression performance by hospital providers.

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Penn State College of Medicine, Hershey, Pennsylvania.
Ohio State University, Department of Emergency Medicine, Columbus, Ohio.



The purpose of this study was to determine cardiopulmonary resuscitation (CPR) knowledge of hospital providers and whether knowledge affects performance of effective compressions during a simulated cardiac arrest.


This cross-sectional study evaluated the CPR knowledge and performance of medical students and ED personnel with current CPR certification. We collected data regarding compression rate, hand placement, depth, and recoil via a questionnaire to determine knowledge, and then we assessed performance using 60 seconds of compressions on a simulation mannequin.


Data from 200 enrollments were analyzed by evaluators blinded to subject knowledge. Regarding knowledge, 94% of participants correctly identified parameters for rate, 58% for hand placement, 74% for depth, and 94% for recoil. Participants identifying an effective rate of ≥100 performed compressions at a significantly higher rate than participants identifying <100 (μ=117 vs. 94, p<0.001). Participants identifying correct hand placement performed significantly more compressions adherent to guidelines than those identifying incorrect placement (μ=86% vs. 72%, p<0.01). No significant differences were found in depth or recoil performance based on knowledge of guidelines.


Knowledge of guidelines was variable; however, CPR knowledge significantly impacted certain aspects of performance, namely rate and hand placement, whereas depth and recoil were not affected. Depth of compressions was poor regardless of prior knowledge, and knowledge did not correlate with recoil performance. Overall performance was suboptimal and additional training may be needed to ensure consistent, effective performance and therefore better outcomes after cardiopulmonary arrest.

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