5 Reasons Why Real-Time Feedback Can Make the Difference

The longer your pre-shock pauses and the shallower your chest compressions, the less likely you will be to achieve defibrillation success. This, of course, applies to a shockable rhythm, VF (ventricular fibrillation) and VT (pulseless ventricular tachycardia).

This finding comes from a study which concluded that each 5 mm increase in compression depth and each 5 second decrease in pre-shock pause shows a doubled increase in the likelihood of shock success after adjusting for arrest location, age, sex and time to shock.3 However, today’s technology, capable of sensing compression rate and depth, has shown that frequent pauses and shallow compression depth are common in clinical practice.³

Real-time feedback can be used to moderate those factors by guiding a CPR provider at the time those factors start to play their destructive role.

According to a study by the AHA in 2006, rescuers often do not compress the chest deeply enough despite recommendations4. Not only did the study validate that every patient's chest resistance is different, it confirmed that chest stiffness decreases significantly with an increasing number of compressions performed during CPR.⁴ In 2006, there was no upper limit on compression depth. Post - 2015 AHA Guidelines, there is: 2-2.4 inches for adults and adolescents.

Given that real-time feedback is now a readily available technology, achieving the right compression depth and setting the stage for defibrillation success should not be a guessing game. If you or your colleagues have ever felt like it is a guessing game, introducing real-time feedback into your program can help to eliminate that feeling.

You've likely heard or used the phrase, "I'm not in the loop." This expression comes from the U.S. Air Force concept of a "control loop" known as the OODA loop. When a pilot says he or she is "out of the loop," it means the pilot can no longer observe, orient, decide, and/or act, when flying on autopilot, for example.

Practitioner or pilot, both are high stakes roles in which autonomy and ownership are critical to success. Real-time feedback by its nature gives practitioners little choice but to be engaged in the OODA loop, which improves situational awareness, team performance, and individual attention to detail during CPR.

The AHA recommends every EMS system, hospital, and other professional rescuer program should have an ongoing CPR CQI (Continuous Quality Improvement) program that provides feedback to the director, managers, and providers.

This kind of program gives providers an opportunity to focus on a long-term vision with long-term goals. Maximizing performance on the five key metrics of quality CPR becomes not only critical to each individual patient case but to the overall success and esprit of the organization.

Real-time feedback can help you create better conditions for defibrillation success, optimized hemodynamics, optimal compressions, provider ownership, and most importantly continuous improvement. Real-time feedback can give you the means to face possible current errors in your performance, but also the assurance that you can and will improve.