CPR can save a life – but only if you’re doing it right
They say that if you break a rib when performing CPR, you’re doing it right. For some patients, it may be a necessary consequence of a life-saving emergency procedure like cardiopulmonary resuscitation (CPR). But how does one know how much is enough, or how much is too much, when pumping someone’s chest and breathing air into their lungs during a cardiac arrest?
“I wanted to make sure I could create a research project that makes a difference,” says Nursing student Felicity Dick-Smith as she remembers why she chose her honours research topic. “CPR is so important, but we’re not educating our students well enough in CPR training,” she continues.
The success rate for CPR is 10% outside of the hospital, and only 20% inside the hospital. Most shocking of all, these numbers haven’t changed in 20 years despite the new technologies invented to improve the effectiveness of CPR. While there are multiple factors that can contribute to the failure of CPR attempts, the evidence from Felicity’s honours research indicates that current teaching methods could also be a contributing factor.
Supported by a $10,000 scholarship from St John Ambulance Australia, Felicity’s research compared multiple objective CPR feedback technologies. Often, CPR training is delivered by an instructor, who takes the trainees through the necessary steps to learn how to perform CPR and provides subjective feedback along the way. At the end of the course students are assessed on how well they conduct CPR on a manikin by the observing instructor.
If there are 20 people in a room learning how to perform CPR with only one instructor, how can we be sure each student is performing CPR correctly?
64 undergraduate nursing students at UTS were recruited to partake in Felicity’s honours study. First, the students passed an accredited standardised CPR training course donated by St John Ambulance Australia. After three weeks, the students returned and performed CPR on UTS manikins to test their recently acquired CPR knowledge without feedback.
Despite each student rating their CPR attempt as highly successful in a post-test survey, nearly all 64 nursing students failed to meet the standards set by the Australia Resuscitation Council’s guidelines.
Next, the students were educated on three CPR feedback training devices and given two minutes to familiarise themselves with each device:
- The Laerdal Resusci Anne QCPR Manikin (LRAM) and SimPad measures airflow through realistic airway anatomy on the manikin and displays feedback on a tablet system called SimPad.
- The Brayden is a torso CPR training manikin which on the forehead when compressions are correct in depth, speed and thoracic release.
- The TrueCPR device displays feedback via a visual fan graph on a non-invasive dashboard to indicate if compressions are too shallow or deep.
Students were then randomly allocated a device and went on to complete further CPR testing on each of the three devices.
The results of this study show that CPR feedback devices will help students to identify when they are performing CPR effectively and when they are not.
“Having the opportunity to practice and obtain feedback is very useful and helped prepare me to perform real-life CPR in the future…” said one participant.
Felicity’s project was awarded first class honours. She hopes to translate her research into clinical practice and education, including incorporating CPR training with feedback technologies into undergraduate nursing curricula. UTS has already taken the first step with SimPads and Brayden manikins available for student use in the nursing simulation labs.
What’s next for Felicity? She intends to further her impact through PhD research. However, before she becomes Dr Dick-Smith, Felicity plans to develop her critical care nursing career at Royal North Shore Hospital Intensive care unit and in her downtime pursue a desire to learn how to mix and curate music. “Just call me DJ ‘Mixed-Methods’,” she says. “This name honours both my love of research and electronic music.”
Felicity would like to thank and acknowledge all those who took the time to help her complete this research including, St John Ambulance Australia, Dr Tamara Power, Professor Doug Elliott, Dr Roberto Martinez-Maldonado, all participants within this study and her family.