Abstract 93: “Push Hard” Prompts Transiently Increase Depth of Chest Compressions on Manikins by Nurses
Studies that have evaluated CPR quality show that most trained rescuers do not perform at the chest compression depth and rate recommended by international guidelines. Recent work has shown that CPR coaching such as a CPR metronome was effective for compression and ventilation rates. In an effort to improve chest compression depth, we evaluated the effectiveness and usability of a vocal prompt to “Remember to push hard.”
Methods: Critical care nurses were randomized to perform CPR on an intubated, instrumented manikin using an AED with metronome guidance alone (control), or with the metronome plus a prompt to “remember to push hard” every 60 seconds (intervention). Each participant performed chest compressions for 4 minutes, rested for 2 minutes, then completed another 2 minutes of compressions.
Results: Mean weight and height did not differ for 29 control and 18 intervention participants. The compression rate (99±6/min control vs 103±8/min intervention, mean ± standard deviation) and total number of compressions (595±37 vs 616±46) did not differ between groups. Mean compression depth over all six minutes of CPR was 31±9 mm control vs 33±10 mm intervention (NS). For intervention participants the greatest difference in depth occurred around the time of the prompt with a mean depth for the 3 seconds before (33.9±9.1 mm, n=99) vs 3 seconds after (36.8±9.6 mm, n=96) the prompt given at minute 1 (p=0.03). The number of participants that performed any compressions with either excessive depth or incomplete release was not different between groups.
Conclusion: A periodic “push hard” prompt may be effective at improving chest compression depth among trained rescuers and does not result in a decrease in CPR performance. Further work is needed to identify the optimal prompting frequency.
- © 2010 by American Heart Association, Inc.