Improving quality of chest compression in thai emergency department by using real-time audio-visual feedback cardio-pulmonary resuscitation monitoring

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND 2019. Background: High-quality cardiopulmonary resuscitation (CPR) is challenging in real life situations. Real-time audio-visual feedback (RTAVF) during resuscitation could improve CPR quality. Although recent studies showed improvements in CPR quality after using of RTAVF, there has been little data from Asian population, especially in Thailand. Objective: To compared CPR quality before and after use of RTAVF system in a Thai emergency department. Quality was determined in terms of chest compression (CC) depth, rate, and CC fraction. CPR outcomes were also evaluated. Materials and Methods: The present study was a before-and-after study of adult out-of-hospital cardiac arrest (OHCA) patients in the emergency department at a university hospital in Bangkok, Thailand between May and October 2017. Phase I (P1) included 16 patients with standard CPR, and phase II (P2) included 16 patients with RTAVF. CC depth and rate were compared between the two phases. Results: Thirty-two OHCA patients were included. The mean age was 63.4±14.4 years and 68.8% were male. Initial rhythm was ventricular fibrillation in 28.1% of all patients. CC depth was increased from 38.8±11.5 mm in P1 to 48.0±9.2 mm in P2 (p=0.018). CC rate was decreased from 139.3±8.9/minute in P1 to 117.2±7.4/minute in P2 (p<0.001). No significant differences were identified between the two groups in CC fraction, peri-shock pause, ROSC rate, survival to hospital discharge, nor favorable neurological outcome. Conclusion: RTAVF monitoring can improve CPR quality especially in CC depth and rate among OHCA patients in a Thai emergency department without significant changes of long-term cerebro-cardiovascular outcomes.