The use of CPR feedback/prompt devices during training and CPR performance: A systematic review

University of Warwick, UK.
Resuscitation (Impact Factor: 4.17). 08/2009; 80(7):743-51. DOI: 10.1016/j.resuscitation.2009.04.012
Source: PubMed


In lay persons and health care providers performing cardiopulmonary resuscitation (CPR), does the use of CPR feedback/prompt devices when compared to no device improve CPR skill acquisition, retention, and real life performance?
The Cochrane database of systematic reviews; Medline (1950-Dec 2008); EmBASE (1988-Dec 2008) and Psychinfo (1988-Dec 2008) were searched using ("Prompt$" or "Feedback" as text words) AND ("Cardiopulmonary Resuscitation" [Mesh] OR "Heart Arrest" [Mesh]). Inclusion criteria were articles describing the effect of audio or visual feedback/prompts on CPR skill acquisition, retention or performance.
509 papers were identified of which 33 were relevant. There were no randomised controlled studies in humans (LOE 1). Two non-randomised cross-over studies (LOE 2) and four with retrospective controls (LOE 3) in humans and 20 animal/manikin (LOE 5) studies contained data supporting the use of feedback/prompt devices. Two LOE 5 studies were neutral. Six LOE 5 manikin studies provided opposing evidence.
There is good evidence supporting the use of CPR feedback/prompt devices during CPR training to improve CPR skill acquisition and retention. Their use in clinical practice as part of an overall strategy to improve the quality of CPR may be beneficial. The accuracy of devices to measure compression depth should be calibrated to take account of the stiffness of the support surface upon which CPR is being performed (e.g. floor/mattress). Further studies are needed to determine if these devices improve patient outcomes.

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    • "An extensive body of research shows that CPR knowledge and skills decline rapidly following completion of a CPR course, while CPR psychomotor skills decline even more quickly (Hamilton, 2005 as cited in Oermann et al., 2010; Madden, 2006; Moser & Coleman, 1992). Conversely, Yeung et al. (2009) found that there was " good } } "
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    • "High compression fraction was independently predictive of better survival in patients who experience a prehospital ventricular fibrillation/tachycardia cardiac arrest [3,4]. However, there is little if any data demonstrating that quality controlled CPR actually improves patient outcome in out of hospital setting [21,24,25]. This may be reflected in emergency physicians’ attitudes and result in low utilisation of the quality analysis feature. "
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    • "This is reflected by the fact that, in three centres, intensive training is provided in the use of special supportive devices, which are used extensively. Bonn has established LDB CPR use [37,49], ACD-CPR is applied in connection with an impedance valve in Göppingen [50] and, after intensive training and continuous scientific evaluation, a CPR feedback system is regularly used in Münster [51,52]. In this study, we found no evidence that using these mechanical or feedback devices increases CPR success. "
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