References
Paramedic-reported barriers towards use of CPR feedback devices in Perth, Western Australia
Abstract
Feedback devices for cardiopulmonary resuscitation (CPR) have been introduced across a number of emergency medical services (EMS) worldwide with the intention of increasing the provision of high quality CPR. In July 2014, St. John Ambulance Western Australia (SJA-WA) introduced the Q-CPRTM device into mandatory clinical practice; however usage rates were lower than expected.
Methods:
A voluntary, anonymous survey was issued to a convenience sample of SJA-WA paramedics from September to December 2015 to determine the paramedic-reported barriers towards the use of Q-CP
Results:
Of the 264 paramedics who participated in the survey, 41% reported having used Q-CPR during their last attempted resuscitation. Among those who had not used it, the reason most commonly cited (37%) was that a mechanical chest compression device arrived on scene prior to the Q-CPR being deployed. Secondly, other interventions were prioritized above the use of Q-CPR (20%). Thirdly, pain associated with use of the Q-CPR prevented its utilization in 17% of cases. Other reasons were less frequently reported.
Conclusion:
Lower usage rates appeared to be primarily linked to the utilisation of other equipment and interventions in preference to the Q-CPR and to a lesser extent due to pain associated with the use of such devices.
High quality cardiopulmonary resuscitation (CPR) has been linked to improved survival outcomes for cardiac arrest patients (Kramer-Johansen et al, 2006; Babbs et al, 2008; Christenson et al, 2009; Stiell et al, 2014; Sutton et al, 2014; Vadeboncoeur et al, 2014; Idris et al, 2015; Perkins et al, 2015a; Perkins et al, 2015b; Talikowska et al, 2015). To promote the delivery of high quality CPR by healthcare professionals, a number of Emergency Medical Services (EMS) worldwide have introduced CPR feedback devices into routine clinical use. An example of one such device is the Q-CPRTM developed by Laerdal Medical and Philips Healthcare. It comprises a force sensor and an accelerometer, and, placed underneath the hands of the rescuer, it delivers both visual and (optional) auditory feedback to the user in real-time about their CPR performance. Specifically, it provides feedback on parameters such as compression depth, compression rate, adequate chest recoil and time without compressions (‘hands-off time’). In addition, information about ventilation rate is captured by measuring transthoracic impedance using the multifunction defibrillation pads (Laerdal Medical Corportation, 2016, Philips Healthcare, 2011).
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