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The use of popular audio in CPR (TUPAC)—Does music improve compliance with recommended chest compression rates?

2010; Elsevier BV; Volume: 81; Issue: 5 Linguagem: Inglês

10.1016/j.resuscitation.2010.01.004

1873-1570

Mohammed Naushaduddin, Anna Holdgate, Setthy Ung,

Palliative Care and End-of-Life Issues

While international resuscitation guidelines recommend chest compression rates of 100/min, previous studies have demonstrated poor compliance with this rate by trained rescuers.1Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: International consensus on science.Circulation. 2000; 102: I1-I384PubMed Google Scholar, 2Kaye W. Mancini M.E. Retention of cardiopulmonary resuscitation skills by physicians, registered nurses and the general public.Crit Care Med. 1986; 14: 620-622Crossref PubMed Scopus (158) Google Scholar We aimed to study whether compliance with recommended chest compression rates would improve with the use of a well known musical tune to aid in timing of chest compressions. The use of such a musical ‘aide memoir’ is often suggested in life support courses3Inabe A. Perfect teaching tool for training compressions and it's Disco!.Curr Emerg Cardiovasc Care. 2006; 17: 7Google Scholar but we could find no evidence to support its effectiveness in maintaining compliance with compression rates in clinicians who have already been trained in basic life support. Emergency department nurses and doctors were individually asked to perform chest compressions for 1 min on a mannequin, based on their usual practice. After a short break each staff member was shown a video clip of the Bee Gees song “Staying Alive” which has a beat of 103/min. They were then asked to perform another minute of chest compression using the tempo of the tune that they had just listened to. The rate of chest compression was measured using a software program integrated within the mannequin. Differences in chest compression rates before and after exposure to the music clip were compared and differences based on staff grade, gender, age, cultural background and basic life support training were also examined. Twenty-six nurses and 21 doctors participated in the study. Two-thirds of the participants were women and two-thirds were aged between 25 and 34 years. All but eight participants had undergone basic life support (BLS) training or recertification within the past 3 years. The rate of chest compressions in the first cycle ranged from 80 to 180/min with a mean of 130.2/min. After instruction to time cardiac compressions to the ‘Stayin Alive’ tune, the rate of chest compressions in the second cycle ranged from 71 to 153/min with a mean of 117.3/min. This difference in compression rates between the first and second cycles was significant (mean difference 13.0/min, 95% CI 6.5–19.0, P < 0.001). The change in compression rates before and after listening to the music clip was not significantly influenced by age, gender, cultural background or seniority. During the first round of measurement, nurses performed chest compressions significantly faster than doctors (137/min vs. 122/min, P < 0.01). However, after instruction there was no significant difference in compression rates between nurses and doctors (117/min vs. 118/min, P = 0.8). In our study ED doctors and nurses performed chest compressions at significantly higher rates than currently recommended by guidelines. While we found that cardiac compression rates did improve with the use of a ‘mental metronome’, this improvement was seen only in nursing staff and the rate continued to be much faster than recommended. Nurses significantly modified their rates of compression after instruction to time compressions to a musical rhythm, but both doctors and nurses continued to deliver chest compressions at faster than recommended rates following instruction. This was despite nearly all participants having completed basic life support competency testing in the recent past. All authors declare that they have no financial or personal relationships with other people or organisations that could inappropriately influence this work.