Real-time feedback for CPR quality - A scoping review

Siobhán Masterson; Tatsuya Norii; Mio Yabuki; Takaya Ikeyama; Ziad Nehme; Janet Bray; BLS ILCOR Task Force

doi:10.1016/j.resplu.2024.100730

Real-time feedback for CPR quality - A scoping review

Resusc Plus. 2024 Jul 31:19:100730. doi: 10.1016/j.resplu.2024.100730. eCollection 2024 Sep.

Authors

Siobhán Masterson^{1

2

3}, Tatsuya Norii⁴, Mio Yabuki⁵, Takaya Ikeyama^{6

7}, Ziad Nehme^{8

9}, Janet Bray¹⁰; BLS ILCOR Task Force

Affiliations

¹ National Ambulance Service, Health Service Executive, Limerick, Ireland.
² Discipline of General Practice, University of Galway, Ireland.
³ School of Medicine, University College Cork, Ireland.
⁴ School of Medicine, University of New Mexico, Albuquerque, United States.
⁵ Faculty of Medicine, Nippon Medical School, Tokyo, Japan.
⁶ Center for Pediatric Emergency and Critical Care Medicine, Aichi Children's Health and Medical Center, Japan.
⁷ Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Japan.
⁸ School of Public Health and Preventive Medicine, Monash University, Australia.
⁹ Centre for Research and Evaluation, Ambulance Victoria, Australia.
¹⁰ Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Australia.

Abstract

Background: Previous systematic reviews have failed to find an association between the use of real-time feedback during cardiopulmonary resuscitation (CPR) and patient outcomes. However, these reviews excluded studies examining feedback with other system changes. As part of the International Liaison Committee on Resuscitation (ILCOR) continuous evidence evaluation process, we conducted a scoping review to examine the current state of this literature and the use of real-time feedback in this form.

Methods/data sources: A protocol and search strategy was developed. We searched Medline, EMBASE, and Allied Health Literature (CINAHL) from inception to May 2024. Cochrane (Cochrane (specifically, the Cochrane Database of Systematic Reviews) is contained in Medline so was not searched separately. Studies were eligible for inclusion if they were published or unpublished (grey-literature) studies involving children or adults that examined the effect of real-time feedback or prompting on the quality of CPR following cardiac arrest. Data were extracted and audited independently. For each study, the following information were extracted: the author(s); year of publication; timeframe; study design; country; population; intervention and comparator; type of feedback or prompt; outcomes measured; main findings for CPR quality, and; main findings for patient outcomes. Reviewers also allocated key themes to each study and held a series of consensus discussions to consolidate themes across the included studies.

Results: We screened 2,657 titles and included 60 studies. Our analysis identified five overlapping themes in the extended literature: system change and quality improvement; impact on patient outcomes; better CPR quality without improved patient outcome; CPR feedback as a generator of other CPR metrics; and CPR feedback as a potential harm. Results revealed a substantial adjacent literature, particularly on implementing high-performance CPR as part of quality improvement programs.

Conclusions: This scoping review has identified a large body of literature and specific themes of interest in relation to feedback for CPR quality. Future systematic reviews should include studies examining real-time feedback with other system changes.

Keywords: CPR feedback devices; Cardiopulmonary resuscitation; Real-time CPR feedback; Scoping review.

Publication types

Review