The use of CPR feedback/prompt devices during training and CPR performance: A systematic review.

OBJECTIVES In lay persons and health care providers performing cardiopulmonary resuscitation (CPR), does the use of CPR feedback/prompt devices when compared to no device improve CPR skill acquisition, retention, and real life performance? METHODS The Cochrane database of systematic reviews; Medline (1950-Dec 2008); EmBASE (1988-Dec 2008) and Psychinfo (1988-Dec 2008) were searched using ("Prompt$" or "Feedback" as text words) AND ("Cardiopulmonary Resuscitation" [Mesh] OR "Heart Arrest" [Mesh]). Inclusion criteria were articles describing the effect of audio or visual feedback/prompts on CPR skill acquisition, retention or performance. RESULTS 509 papers were identified of which 33 were relevant. There were no randomised controlled studies in humans (LOE 1). Two non-randomised cross-over studies (LOE 2) and four with retrospective controls (LOE 3) in humans and 20 animal/manikin (LOE 5) studies contained data supporting the use of feedback/prompt devices. Two LOE 5 studies were neutral. Six LOE 5 manikin studies provided opposing evidence. CONCLUSIONS There is good evidence supporting the use of CPR feedback/prompt devices during CPR training to improve CPR skill acquisition and retention. Their use in clinical practice as part of an overall strategy to improve the quality of CPR may be beneficial. The accuracy of devices to measure compression depth should be calibrated to take account of the stiffness of the support surface upon which CPR is being performed (e.g. floor/mattress). Further studies are needed to determine if these devices improve patient outcomes.