Effect of the use of metronome feedback on the quality of pediatric cardiopulmonary resuscitation

Abstract

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.