Accuracy of Healthcare Providers' Perception of Chest Compression Depth and Chest Recoil

Objective: The objective of this paper was to evaluate the validity and accuracy of healthcare providers’ perception of chest compression depth and chest recoil during cardiopulmonary resuscitation (CPR). Methods: A clinical simulation study was performed with healthcare providers trained in CPR including physicians, nurses, and Emergency Medical Technicians (EMT). Following 2 minutes of hands-only-CPR on a sensor-programmed manikin, providers were able to respond to subjective questions assessing their adequacy of CPR. The providers’ perception contrasted with the objective data obtained from the manikin. The validity and accuracy of CPR providers’ perception of chest compression depth and chest recoil was assessed by the calculation of sensitivity, specificity and predictive values. Results: 180 Advanced or basic life support certified healthcare providers were enrolled. The degree of correlation between self-perception and actual performance was 52.2% in the thoracic compression depth and 61.7% in the chest recoil. Caregivers’ perception of chest compression depth had a sensitivity of 29.4% and a specificity of 87.3%. Caregivers’ perception of chest recoil had a sensitivity of 30.3% and a specificity of 79.8%. Conclusions: Healthcare providers’ perception for evaluating the accuracy of thoracic compressions is not as accurate as objective feedback methods during CPR. This may impact patient outcomes during a cardiac arrest.

Cardiopulmonary resuscitation, Heart massage, Cardiac arrest, Simulation

[1] Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T et al. European resuscitation council guidelines for resuscitation 2015: section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015;95:81-99.

[2] Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F et al. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital:a consensus statement from the American Heart Association. Circulation. 2013;128:417-35.

[3] Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von Briesen C, Sparks CW et al. Incomplete chest wall decompression: a clinical evaluation of CPR performance by EMS personnel and assessment of alternative manual chest compression-decompression techniques. Resuscitation. 2005;64:353-62.

[4] Brennan EE, McGraw RC, Brooks SC. Accuracy of instructor as-sessment of chest compression quality during simulated resuscitation. CJEM 2016;18:276-82.

[5] Wang JC, Tsai SH, Chen YH, Chen YL, Chu SJ, Liao WI. Kinect-based real-time audiovisual feedback device improves cardiopul-monary resuscitation quality of lower-body-weight rescuers. Am J Emerg Med. 2018;36:577-82.

[6] Calvo-Bueya JA, Calvo-Marcos D, Marcos-Camina RM. Estudio aleatorizado de la relación entre el uso del dispositivo CPRmeter® y la calidad de las compresiones torácicas en una resucitación cardiopulmonar simulada. Enferm Intensiva. 2016;27:13-21.

[7] Cheng A, Overly F, Kessler D, Nadkarni VM, Lin Y, Doan Q et al. Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role. Resuscitation. 2015;87:44-50.

[8] Bobrow BJ, Vadeboncoeur TF, Stolz U, Silver AE, Tobin JM, Crawford SA et al. The influence of scenario-based training and real-time audiovisual feedback on out-of-hospital cardiopulmonary resuscitation quality and survival from out-of-hospital cardiac arrest. Ann Emerg Med. 2013;62:47-56.

[9] González-Otero DM, Russell JK, Ruiz JM, Ruiz de Gauna S, Gutiérrez JJ, Leturiondo LA et al. Association of chest compression and recoil velocities with depth and rate in manual cardiopulmonary resuscitation. Resuscitation. 2019;142:119-26.