Chest Compression and Ventilation Rates during Cardiopulmonary Resuscitation: The Effects of Audible Tone Guidance
Article first published online: 29 SEP 2008
© 1995 Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 2, Issue 8, pages 708–713, August 1995
How to Cite
Milander, M. M., Hiscok, P. S., Sanders, A. B., Kern, K. B., Berg, R. A. and Ewy, G. A. (1995), Chest Compression and Ventilation Rates during Cardiopulmonary Resuscitation: The Effects of Audible Tone Guidance. Academic Emergency Medicine, 2: 708–713. doi: 10.1111/j.1553-2712.1995.tb03622.x
- Issue published online: 29 SEP 2008
- Article first published online: 29 SEP 2008
- Received: August 10, 1994 Revision received: November 1, 1994 Accepted: November 16, 1994
- cardiopulmonary resuscitation;
- cardiac arrest;
- chest compression;
Objectives: To determine: 1) whether chest compressions during CPR are being performed according to American Heart Association (AHA) guidelines during cardiac arrest; and 2) the effect of an audio prompt to guide chest compressions on compliance with AHA guidelines and hemodynamic parameters associated with successful resuscitation.
Methods: An observational clinical report and laboratory study was conducted. A research observer responded to a convenience sample of cardiac arrests within a 300-bed hospital and counted the rate of chest compressions and ventilations during CPR. To evaluate the effect of an audio prompt on CPR, health care providers performed chest compression without guidance using a porcine cardiac arrest model for 1 minute, followed by a second minute in which audio guidance was added. Chest compression rates, arterial and venous blood pressures, end-tidal CO2 (ETCO2) levels, and coronary perfusion pressures were measured and compared for the two periods.
Results: Twelve in-hospital cardiac arrests were observed in the clinical part of the study. Only two of 12 patients had chest compressions performed within AHA guidelines. No patient had respirations performed within AHA guidelines. In the laboratory, 41 volunteers were tested, with 66% performing chest compressions outside the AHA standards for compression rate without audible tone guidance. With guided chest compressions, the mean (± SD) chest compression rate increased from 74 ± 22 to 100 ± 3/min (p < 0.01). End-tidal CO2 levels increased from 15 ± 7 to 17 ± 7 torr (p < 0.01). Coronary perfusion pressure increased minimally with audible tone-guided chest compressions.
Conclusions: The majority of Basic Cardiac Life Support-certified health care professionals did not perform CPR according to AHA-recommended guidelines. The use of audible tones to guide chest compression resulted in significantly higher chest compression rates and ETCO2 levels.