Abstract 220: Analysis of Actual CPR Through a Review of YouTube Video: Poor Performance Is Common in Professional and Lay Rescuers
INTRODUCTION: Numerous studies have shown the performance of CPR in both prehospital and hospital settings often fails to meet recommended standards. We sought to analyze the quality of lay rescuer (LR) and professional rescuer (PR) CPR performance in real resuscitation events captured on video on the website YouTube.com.
METHODS: We searched YouTube for videos of actual adult CPR recorded by bystanders. Videos which were staged for teaching, commercial use or entertainment were excluded. A convenience sample of 50 videos of CPR (in and out-of-hospital) was analyzed. Demographics and CPR quality parameters were collected. Compression depth was subjectively evaluated as adequate or inadequate (ie. not forceful enough).
RESULTS: The 50 videos collected were uploaded between 12/2009 and 2/2011. They ranged from :07 to 9:57 minutes in length. Forty-two of 50 (84%) were of out-of-hospital arrests. CPR was done by LR in 17 and PR in 43. The mean chest compression (CC) rate was 110/m (SD 30, range 49-200) for all rescuers, 101/m (SD 29, range 46-166) for LR and 113/m (SD 28, range 49-200) for PR. In both groups, 40% of CC were slower than the recommended rate of 100/m. Inadequate release or leaning was seen in 66% of the time overall (11/17 (65%) of LR and 23/43 (53%) of PR). CC depth was adequate in 18/50 (36%) for both groups (3/17 for LR and 17/43 for PR). Depth was inadequate in 31/50 (62%) for both groups (14/17 for LR and 25/43 for PR). Compression depth adequacy was indeterminate in 1 video where the chest could not be seen. The mean time for rescue breath delivery was 7.8s (SD 4.4, range 3.4-25) overall, 6.3s (SD 3.1) for LR, 14.7s (SD 5.2) for PR. For PR, the mean ventilation rate by BVM alone or after intubation was 31/m (SD 17, range 3-66). 88% of ventilations were faster than the recommended 8-10/m.
CONCLUSIONS: In actual bystander-recorded CPR, typical measures of CPR quality are often poor. Slow compression rates, excessive ventilation and significant periods of ‘leaning’ are common, in lay as well as professional rescuers. Mean CC rate is close to recommended rates, but with a very wide range making overall compliance poor. Poor compression depth was more common in LR CPR.
- © 2011 by American Heart Association, Inc.