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Can a Software-Based Metronome Tool Enhance Compression Rate in a Realistic 911 Call Scenario Without Adversely Impacting Compression Depth for Dispatcher-Assisted CPR?

Published online by Cambridge University Press:  23 July 2018

Greg Scott ,
Tracey Barron ,
Isabel Gardett ,
Meghan Broadbent ,
Holly Downs ,
Leslie Devey ,
EJ Hinterman ,
Jeff Clawson  and
Christopher Olola
Greg Scott
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, UtahUSA
Tracey Barron
Affiliation:
International Academies of Emergency Dispatch, Bristol, United Kingdom
Isabel Gardett
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, UtahUSA
Meghan Broadbent
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, UtahUSA
Holly Downs
Affiliation:
Salt Lake Valley Emergency Communications Center, West Valley, UtahUSA
Leslie Devey
Affiliation:
Salt Lake Valley Emergency Communications Center, West Valley, UtahUSA
EJ Hinterman
Affiliation:
United Fire Authority, Salt Lake City, UtahUSA
Jeff Clawson*
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, UtahUSA
Christopher Olola
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, UtahUSA
*
Correspondence: Isabel Gardett, PhD International Academies of Emergency Dispatch 110 Regent Street Salt Lake City, Utah 84111 USA E-mail: isabel.gardett@emergencydispatch.org
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Abstract

Introduction

Implementation of high-quality, dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is critical to improving survival from out-of-hospital cardiac arrest (OHCA). However, despite some studies demonstrating the use of a metronome in a stand-alone setting, no research has yet demonstrated the effectiveness of a metronome tool in improving DA-CPR in the context of a realistic 911 call or using instructions that have been tested in real-world emergency calls.

Hypothesis

Use of the metronome tool will increase the proportion of callers able to perform CPR within the target rate without affecting depth.

Methods

The prospective, randomized, controlled study involved simulated 911 cardiac arrest calls made by layperson-callers and handled by certified emergency medical dispatchers (EMDs) at four locations in Salt Lake City, Utah USA. Participants were randomized into two groups. In the experimental group, layperson-callers received CPR pre-arrival instructions with metronome assistance. In the control group, layperson-callers received only pre-arrival instructions. The primary outcome measures were correct compression rate (counts per minute [cpm]) and depth (mm).

Results

A total of 148 layperson-callers (57.4% assigned to experimental group) participated in the study. There was a statistically significant association between the number of participants who achieved the target compression rate and experimental study group (P=.003), and the experimental group had a significantly higher median compression rate than the control group (100 cpm and 89 cpm, respectively; P=.013). Overall, there was no significant correlation between compression rate and depth.

Conclusion:

An automated software metronome tool is effective in getting layperson-callers to achieve the target compression rate and compression depth in a realistic DA-CPR scenario.

Scott G, Barron T, Gardett I, Broadbent M, Downs H, Devey L, Hinterman EJ, Clawson J, Olola C. Can a software-based metronome tool enhance compression rate in a realistic 911 call scenario without adversely impacting compression depth for dispatcher-assisted CPR? Prehosp Disaster Med. 2018;33(4):399–405

Keywords

automated metronomedispatcher-assisted CPRemergency dispatch protocolsemergency medical dispatchMedical Priority Dispatch Systempre-arrival instructions
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 4 , August 2018 , pp. 399 - 405
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest: Dr. Clawson is the original creator of the MPDS protocol system studied. All other authors have no conflicts of interest to declare.

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