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New performance study highlights benefits of CPR sensing technology

Philips Medical Systems : 27 May, 2008  (Company News)
Philips has announced the results of a study confirming the benefit of using CPR sensing and recording technology to improve CPR performance.
Published in the Archives of Internal Medicine, the study revealed that providing objective metrics and educational feedback to medical personnel who performed CPR on a cardiac arrest patient significantly improved ventilation rate, compression rate and depth of compression. The improvement in CPR performance in a clinical setting was associated with higher initial survival rates for cardiac arrest patients.

'Similar to post-game analysis for professional athletes, medical responders were able to learn from their past resuscitation performance and apply this knowledge to future resuscitations,' said Dr Dana Edelson, director of Clinical Research for the Emergency Resuscitation Center at the University of Chicago Medical Center, and co-investigator of the study. 'The results of this study suggest that CPR performance review has broad applicability for improving resuscitation training.'

Results drawn from medical professionals participating in the Resuscitation with Actual Performance Integrated Debriefing (RAPID) trials were published in the study, ‘Improving In-Hospital Cardiac Arrest Process and Outcomes using Performance Debriefing’. The Philips HeartStart MRx with Q-CPR Measurement and Feedback was used to record resuscitation performance during actual cardiac arrest events. Medical professionals then participated in weekly debriefing sessions to review transcripts from the prior week's resuscitations and analyse CPR performance including chest compression rate and depth, ventilation rate, and undesired pauses in compressions.

Only in recent years has it been possible to measure CPR performance in a clinical setting. With its data collection and review capabilities, Q-CPR allows resuscitation leaders in hospitals to use valuable feedback from actual cardiac arrest cases to supplement classroom-based training methodologies for professional responders.

The trial results demonstrate that CPR performance quality improved for study participants who received post-resuscitation feedback compared to a control group of professionals who did not receive educational intervention. Specifically, the results show that:

- During the educational intervention period, there was significant improvement on CPR performance measures, compared to the control period including:

- Faster chest compressions
- Deeper chest compressions
- Decreased pauses in chest compressions, in general, as well as around the time of defibrillation
- Decreased ventilation rates
- These improvements in CPR performance correlated with an increased rate of initial survival (or 'return of spontaneous circulation', also termed ‘ROSC’) in the RAPID group.

In recent years, several studies documented that medical professionals were performing poor CPR that deviated from consensus guidelines, despite rescuer training and certification.(Refs 1, 2, 3). These studies were a catalyst for the 2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care to place a renewed emphasis on CPR training and education (Ref 4). Yet, two years later, there is still a need for novel CPR training techniques to improve quality.

'As the trial demonstrates, balancing the correct number of breaths with the exact depth and rate of chest compressions in real-life CPR performance is actually a very complex process with a high likelihood of human error,' said Benjamin S Abella, MD MPhil, assistant professor, Department of Emergency Medicine, University of Pennsylvania, and co-investigator of the study. 'A focused educational debriefing program using data provided by the HeartStart MRx with Q-CPR technology helps emergency responders deliver quality CPR consistently, even in the most stressful and fast-paced environments.'

Quality CPR and early defibrillation are inextricably linked - the combination is essential to increase the survival rate for victims of cardiac arrest. Q-CPR, available only on the Philips HeartStart MRx Monitor/Defibrillator, is the first and only comprehensive technology integrated into a monitor/defibrillator that provides real-time CPR monitoring and feedback for both chest compressions and ventilations (breaths). The technology, developed by Philips and Laerdal, offers medical professionals corrective feedback on the rate and depth of chest compressions, as well as the frequency and quality of ventilations, encouraging them to adjust their technique as needed to improve CPR.

'Studies such as the RAPID trial reinforce the need to better integrate CPR solutions with early defibrillation. We believe this to be the most promising path to improving survival rates for the thousands of victims of cardiac arrest each year,' said Michael Miller, senior vice president of Cardiac Care for Philips Healthcare. 'As a worldwide leader in resuscitation, Philips is dedicated to offering integrated solutions such as the HeartStart MRx with Q-CPR, to raise the bar in quality of resuscitation and ultimately improve patient outcomes.'

Ref 1 - Wik L. Kramer-Johansen J, Myklebust H, et al. Quality of Cardiopulmonary Resuscitation During Out-of-Hospital Cardiac Arrest. JAMA. Jan 19 2005; 293 (3): 299-304.

Ref 2 - Abella BS, Alvarado JP, Myklebust H, et al. Quality of Cardiopulmonary Resuscitation During In-Hospital Cardiac Arrest. JAMA. Jan 19 2005; 293 (3) 305-310.

Ref 3 - Valenzuela TD, Kern KB, Clark LL, et al. Interruptions of Chest Compressions During Emergency Medical Systems Resuscitation. Circulation. August 30 2005: 112 (9): 1259-1265. 2005

Ref 4 - 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. Dec 14 2005; 112 (24 Suppl): IV1-203.
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