Feedback on chest compression quality variables and their relationship to rate of return of spontaneous circulation

Background: Studies have revealed failure to follow international guidelines for performing chest compressions in cardiopulmonary resuscitation (CPR). Certain feedback devices are available for use. One such device (the Q-CPR) has been used in the Madrid Emergency and Rescue Service (SAMUR). Objectives. To analyze whether there is an association between the rate of return of spontaneous circulation (ROSC) and the use of a feedback device, to describe the performance of compressions in comparison with quality standards, and to determine whether any of the measured variables are related to the rate of ROSC. Methods: Prospective cohort study. Recruitment period: November 2007 to December 2010. Inclusion criteria: patients with cardiorespiratory arrest attended by the SAMUR. Exposure factor: use of a CPR measurement and feedback device. Results: SAMUR attended 892 cases of cardiorespiratory arrest: the Q-CPR was used in 108 patients and 784 were given CPR without the device. Potential clinical and laboratory predictors were compared between the 2 cohorts. ROSC occurred in 46% in the Q-CPR cohort and 41% in the cohort without the device (P=.267). The Q-CPR recorded a mean (SD) of 105.7 (7.9) compressions per minute, with a mean depth of 41 (4.76) mm, and a percentage of adequate depth of 76.5% (17.6%). Complete chest recoil did not occur in 223 (13.26%) compressions per event, and this factor was significantly associated with ROSC (P<.05). The variable that was associated with ROSC in patients who had asystole at onset was the percentage of compressions with adequate depth; in patients with asystole or ventricular fibrillation at onset, the mean number of compressions followed by complete chest recoil was associated with the ROSC rate (P<.05). No factors were associated with ROSC in patients with pulseless electrical activity. Conclusions: The Q-CPR device effectively measures resuscitation components and promptly corrects them. Our findings allow us to say that 74.73% of our compressions are of adequate depth; this rate is higher than reports for CPR without feedback devices. The ROSC rate tended to be higher when the Q-CPR was used in this study. Allowing for complete chest recoil is crucial for improving the ROSC rate. [Emergencias 2013;25:99-104]