Does dual operator CPR help minimize interruptions in chest compressions?

Aims: Basic Life Support Guidelines 2005 emphasise the importance of reducing interruptions in chest compressions (no-flow duration) yet at the same time stopped recommending Dual Operator CPR. Dual Operator CPR (where one rescuer does ventilations and one chest compressions) could potentially minimize no-flow duration compared to Single Operator CPR. This study aims to determine if Dual Operator CPR reduces no-flow duration compared to Single Operator CPR. Methodology: This was a prospective randomised controlled crossover trial. Medical students were randomised into 'Dual Operator' or 'Single Operator' CPR groups. Both groups performed 4 min of CPR according to their group allocation on a resuscitation manikin before crossing over to perform the other technique one week later. Results: Fifty participants were recruited. Dual Operator CPR achieved slightly lower no-flow durations than the Single Operator CPR (28.5% (S.D. = 3.7) versus 31.6% (S.D. = 3.6), P <= 0.001). Dual Operator CPR was associated with slightly more rescue breaths per minute (4.9 (S.D. = 0.5) versus 4.5 (S.D. = 0.5), P = 0.009. There was no difference in compression depth, compression rate, duty cycle, rescue breath flow rate or rescue breath volume. Conclusions: Dual Operator CPR with a compression to ventilation rate of 30: 2 provides marginal improvement in no-flow duration but CPR quality is otherwise equivalent to Single Operator CPR. There seems little advantage to adding teaching on Dual Operator CPR to lay/trained first responder CPR programs

An evaluation of objective feedback in basic life support (BLS) training

Background: Studies show that acquisition and retention of BLS skills is poor, and this may contribute to low survival from cardiac arrest. Feedback from instructors during BLS training is often lacking. This study investigates the effects of continuous feedback from a manikin on chest compression and ventilation techniques during training compared to instructor feedback atone. Materials and methods: A prospective randomised controlled trial. First-year healthcare students at the University of Birmingham were randomised to receive training in standard or feedback groups. The standard group were taught by an instructor using a conventional manikin. The feedback group used a 'Skillreporter' manikin, which provides continuous feedback on ventilation volume and chest compression depth and rate in addition to instructor feedback. SkiR acquisition was tested immediately after training and 6 weeks later. Results: Ninety-eight participants were recruited (conventional n = 49; Skillreporter n=49) and were tested after training. Sixty-six students returned (Skillreporter n = 34; conventional n = 32) for testing 6 weeks later. The Skillreporter group achieved better compression depth (39.96 mm versus 36.71 mm, P < 0.05), and more correct compressions (58.0% versus 40.4%, P < 0.05) at initial testing. The Skillreporter group also achieved more correct compressions at week 6 (43.1% versus 26.5%, P < 0.05). Conclusions: This study demonstrated that objective feedback during training improves the performance of BILS skills significantly when tested immediately after training and at re-testing 6 weeks later. However, CPR performance declined substantiary over time in both groups. (c) 2006 Elsevier Ireland Ltd. AR rights reserved