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Training approaches for the deployment of a mechanical chest compression device: a randomised controlled manikin study
  1. Keith Couper1,2,
  2. Rochelle M Velho1,2,
  3. Tom Quinn3,
  4. Anne Devrell4,
  5. Ranjit Lall1,
  6. Barry Orriss4,
  7. Joyce Yeung1,2,
  8. Gavin D Perkins1,2
  1. 1 Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
  2. 2 Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK
  3. 3 Faculty of Health, Social Care and Education, Kingston University and St George’s, University of London, London, UK
  4. 4 Patient and Public representative, University of Warwick, Coventry, UK
  1. Correspondence to Dr Keith Couper; k.couper{at}warwick.ac.uk

Abstract

Objectives To evaluate the effect of training strategy on team deployment of a mechanical chest compression device.

Design Randomised controlled manikin trial.

Setting Large teaching hospital in the UK.

Participants Twenty teams, each comprising three clinicians. Participating individuals were health professionals with intermediate or advanced resuscitation training.

Interventions Teams were randomised in a 1:1 ratio to receive either standard mechanical chest compression device training or pit-crew device training. Training interventions lasted up to 1 h. Performance was measured immediately after training in a standardised simulated cardiac arrest scenario in which teams were required to deploy a mechanical chest compression device.

Primary and secondary outcome measures Primary outcome was chest compression flow fraction in the minute preceding the first mechanical chest compression. Secondary outcomes included cardiopulmonary resuscitation quality and mechanical device deployment metrics, and non-technical skill performance. Outcomes were assessed using video recordings of the test scenario.

Results In relation to the primary outcome of chest compression flow fraction in the minute preceding the first mechanical chest compression, we found that pit-crew training was not superior to standard training (0.76 (95% CI 0.73 to 0.79) vs 0.77 (95% CI 0.73 to 0.82), mean difference −0.01 (95% CI −0.06 to 0.03), P=0.572). There was also no difference between groups in performance in relation to any secondary outcome.

Conclusions Pit-crew training, compared with standard training, did not improve team deployment of a mechanical chest device in a simulated cardiac arrest scenario.

Trial registration number ISRCTN43049287; Pre-results.

  • adult intensive and critical care
  • clinical trials

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Footnotes

  • Contributors KC conceived and designed the study, acquired the data, analysed the data, contributed to interpretation of the data, critically revised the manuscript for important intellectual content, drafted the manuscript and approved the final manuscript. RMV analysed the data, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. TQ conceived and designed the study, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. AD conceived and designed the study, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. RL conceived and designed the study, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. BO conceived and designed the study, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. JY contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript. GDP conceived and designed the study, contributed to interpretation of the data, critically revised the manuscript for important intellectual content and approved the final manuscript.

  • Funding KC and JY are supported as NIHR postdoctoral research fellows. GDP is an NIHR senior investigator. This research was funded by an NIHR Postdoctoral Research Fellowship (PDF 2015-08-109).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funder had no role in the design of the study, data collection, data analysis and interpretation or the writing of the manuscript.

  • Competing interests KC, TQ, RL, JY and GDP report that their organisations have received funding from NIHR for clinical trials on the use of mechanical chest compression devices.

  • Patient consent Obtained.

  • Ethics approval The study was reviewed and approved by the University of Warwick Biomedical and Scientific Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets generated and analysed during the current study are not publicly available to maintain participant confidentiality but are available from the corresponding author on reasonable request.

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