Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

Study Overview
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Brief Summary
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The purpose of this study is to determine if the use of a metronome improves chest compression rate and depth during cardiopulmonary resuscitation (CPR) on a pediatric manikin.

Detailed Description
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The study will be conducted in the simulation laboratory at Miami Children's Hospital. Chest compressions will be performed on a compression pediatric simulator. It will consist of two main groups randomly assigned to chest compressions without an audible metronome and chest compressions with audible metronomic tones that beep 100 times per minute for chest compressions. The metronome will be used to coach the correct rate. The same people will complete both arms of the study at one visit. Specifically, the participants will do 2 minutes of chest compressions followed by a 15-minute break then another 2 minutes of chest compressions (to avoid fatigue) with an acceptable range for rate 90-110 BPM and depth of 38-51mm. The subjects will be informed about the metronome, but will not be informed about the measured variables, such as rate and depth of chest compressions. However, the participants will be reminded at the beginning of their visit about the PALS card, i.e. appropriate rate and depth. The use of talking people noise from YouTube will be played in the background to fully model a cardiac arrest scenario (to see if participants ignore the metronome) and will be used during each group session. A noise dosimeter will be used to ensure this noise level is the same for each scenario. The manikin's airway will be secured with an endotracheal tube with continuous ventilations so chest compressions can be continued without interruption. Recommendations for chest compression rate and depth are per Pediatric Advanced Life Support (PALS) according to the 2010 American Heart Association (AHA) guidelines. Data will be collected via the manikin which will wirelessly transmit the data (chest compression rate and depth) to a computer. The manikin has CPR sensing and recording technology software built in. This software records sternum movement depth and rate of chest compressions. Criteria for adequate CPR quality are defined as compression rate between 90-110 per minute and compression depth between 38-51mm.

Official Title
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The Use of an Audible Metronome Improves Chest Compression During Cardiopulmonary Resuscitation on a Pediatric Simulation Manikin

Conditions
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Cardiac Arrest

Intervention / Treatment
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* Other: Metronome on
* Other: Metronome off


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: health professionals with a minimum of basic life support training according to the 2010 AHA guidelines capable of performing chest compressions.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: CPR with metronome on<br>Participants will perform two minutes of uninterrupted chest compressions on a pediatric manikin with the metronome on. Data for compression rate and depth will be collected during this time interval. | Other: Metronome on<br>* Metronome on during participants performance of CPR on a pediatric manikin<br>|
| Other: CPR with metronome off<br>Participants will perform two minutes of uninterrupted chest compressions on a pediatric manikin with the metronome off. Data for compression rate and depth will be collected during this time interval. | Other: Metronome off<br>* Metronome off during participants performance of CPR on a pediatric manikin<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Metronome effect on compression rate and depth | The mean of the percentage of compressions that were within an adequate rate (90-110 per minute) and adequate depth (38-51mm) with and without the metronome. | Adequacy of chest compressions (in terms of rate and depth) under each intervention (with and without metronome) was assessed during two minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiopulmonary Resuscitation, Pediatric simulation study, Metronome