Cardiopulmonary resuscitation guidance improves medical students’ adherence to guidelines in simulated cardiac arrest. A randomised cross-over study

BACKGROUND The 2010 Resuscitation Guidelines require high-quality chest compression and rapid defibrillation for patients with ventricular fibrillation with rhythm analysis and defibrillation repeated every 2 min. A lack of adherence to the guidelines by medical students was observed during simulated resuscitation training. OBJECTIVES To assess whether real-time cardiopulmonary resuscitation guidance, including an audiovisual countdown timer, a metronome, a display of the chest compression quality and voice prompts, might improve adherence to the guidelines by medical students. DESIGN Randomised cross-over simulation study. SETTING Studienhospital Munster, Faculty of Medicine University Munster, Germany PARTICIPANTS One hundred and forty-one medical students (fifth year) in 47 teams. INTERVENTION Simulated resuscitation with and without real-time cardiopulmonary resuscitation guidance. MAIN OUTCOME MEASURES The preshock pause, postshock pause, fraction of time without chest compression and defibrillation intervals. Observed quality parameters were chest compression depth and chest compression rate. RESULTS With real-time cardiopulmonary resuscitation guidance, there were improved mean (SD) chest compression rates (105 ± 8 vs. 121 ± 12 bpm; P