1.Improving cardiopulmonary resuscitation (CPR) performance using an audio-visual feedback device for healthcare providers in an emergency department setting in Malaysia: a quasi-experimental study
Ganasan Chelladurai ; Abd Muhaimin Noor Azhar ; Ridzuan Mohd Isa ; Aidawati Bustam ; Rashidi Ahmad ; Murallitharan Munisamy
The Medical Journal of Malaysia 2020;75(5):514-518
Introduction: Cardiopulmonary Resuscitation (CPR) remains
the primary mechanism of resuscitation for cardiac arrest
victims. However, the quality of delivery of CPR varies
widely in different settings, possibly affecting patient
outcomes. This study is aimed to determine the efficacy of
an audio-visual (AV) CPR feedback device in improving the
quality of CPR delivered by healthcare providers.
Methods: This pre-post, single-arm, quasi-experimental
study randomly sampled 140 healthcare providers working
in the Emergency Department of Hospital Ampang, Malaysia.
Parameters of CPR quality, namely chest compression rate
and depth were compared among participants when they
performed CPR with and without an AV CPR feedback
device. The efficacy of the AV CPR feedback device was
assessed using the Chi-square test and Generalised
Estimating Equations (GEE) models.
Results: The use of an AV CPR feedback device increased
the proportion of healthcare providers achieving
recommended depth of chest compressions from 38.6%
(95% Confidence Interval, 95%CI: 30.5, 47.2) to 85.0%
(95%CI: 78.0, 90.5). A similar significant improvement from
39.3% (95%CI: 31.1, 47.9) to 86.4% (95%CI: 79.6, 91.6) in the
recommended rate of chest compressions was also
observed. Use of the AV CPR device significantly increased
the likelihood of a CPR provider achieving recommended
depth of chest compressions (Odds Ratio, OR=13.01;
95%CI: 7.12, 24.01) and rate of chest compressions
(OR=13.00; 95%CI: 7.21, 23.44).
Conclusion: The use of an AV CPR feedback device
significantly improved the delivered rate and depth of chest
compressions closer to American Heart Association (AHA)
recommendations. Usage of such devices within real-life
settings may help in improving the quality of CPR for
patients receiving CPR