Training approaches for the deployment of a mechanical chest compression device: a randomised controlled manikin study

Keith Couper, Rochelle M Velho, Tom Quinn, Anne Devrell, Ranjit Lall, Barry Orriss, Joyce Yeung, Gavin D Perkins
BMJ Open 2018 February 1, 8 (2): e019009

OBJECTIVES: To evaluate the effect of training strategy on team deployment of a mechanical chest compression device.

DESIGN: Randomised controlled manikin trial.

SETTING: Large teaching hospital in the UK.

PARTICIPANTS: Twenty teams, each comprising three clinicians. Participating individuals were health professionals with intermediate or advanced resuscitation training.

INTERVENTIONS: Teams were randomised in a 1:1 ratio to receive either standard mechanical chest compression device training or pit-crew device training. Training interventions lasted up to 1 h. Performance was measured immediately after training in a standardised simulated cardiac arrest scenario in which teams were required to deploy a mechanical chest compression device.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was chest compression flow fraction in the minute preceding the first mechanical chest compression. Secondary outcomes included cardiopulmonary resuscitation quality and mechanical device deployment metrics, and non-technical skill performance. Outcomes were assessed using video recordings of the test scenario.

RESULTS: In relation to the primary outcome of chest compression flow fraction in the minute preceding the first mechanical chest compression, we found that pit-crew training was not superior to standard training (0.76 (95% CI 0.73 to 0.79) vs 0.77 (95% CI 0.73 to 0.82), mean difference -0.01 (95% CI -0.06 to 0.03), P=0.572). There was also no difference between groups in performance in relation to any secondary outcome.

CONCLUSIONS: Pit-crew training, compared with standard training, did not improve team deployment of a mechanical chest device in a simulated cardiac arrest scenario.


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