Efficacy of feed forward and feedback signaling for inflations and chest compression pressure during cardiopulmonary resuscitation in a newborn mannequin

Abstract

Background: The objective of the study was to evaluate a device that supports professionals during neonatal cardiopulmonary resuscitation (CPR). The device features a box that generates an audio-prompted rate guidance (feed forward) for inflations and compressions, and a transparent foil that is placed over the chest with marks for inter nipple line and sternum with LED's incorporated in the foil indicating the exerted force (feedback).

Methods: Ten pairs (nurse/doctor) performed CPR on a newborn resuscitation mannequin. All pairs initially performed two sessions. Thereafter two sessions were performed in similar way, after randomization in 5 pairs that used the device and 5 pairs that performed CPR without the device (controls). A rhythm score was calculated based on the number of CPR cycles that were performed correctly.

Results: The rhythm score with the device improved from 85 ± 14 to 99 ± 2% (P < 0.05). In the control group no differences were observed. The recorded pressures with the device increased from 3.1 ± 1.6 to 4.9 ± 0.8 arbitrary units (P < 0.05). The second performance of the teams showed significant better results for the group with the CPR device compared to the controls.

Conclusion: Feed forward and feedback signaling leads to a more constant rhythm and chest compression pressure during CPR.

Keywords: Cardiopulmonary resuscitation; Newborn; Simulation.

Figure 1

Design of the visual actuator. A force sensitive resistor is integrated as a pressure sensor in the foil at the intersection of marking of sternum and inter nipple line. The visual indicator consists of an embedded set of six parallel semi-annular electroluminescent strips that light up with increasing pressure.

Figure 2

The ROLA design placed over the thorax of a newborn mannequin. The design features clear recognizable marks to be placed over sternum and inter nipple line in order to position the point of chest compressions exactly in the middle of the lower sternum. The effectiveness of external chest compression was measured with a visual indicator that lighted up with increasing pressure. The indicator was calibrated in such a way that compression of the chest up to one third of the diameter of the chest resulted in lighting of five electroluminescent strips.