Audiovisual feedback and quality of CPR

Effective cardiopulmonary resuscitation (CPR) is essential to maximise the chance of a successful outcome after cardiac arrest. In the linked cluster randomised trial (doi:10.1136/bmj.d512), Hostler and colleagues assess the effect of real-time audio and visual feedback in people with an out of hospital cardiac arrest on whom resuscitation was attempted by emergency medical services⇓.1

In October 2010, the International Liaison Committee on Resuscitation (ILCOR) published international consensus recommendations on CPR and emergency cardiovascular care.2 This review concluded that a strong emphasis on delivering high quality chest compressions was essential. Specific recommendations included placing the hands in the centre of the chest; giving at least 100 compressions a minute; and pressing to a depth of at least 5 cm. Unfortunately, although the recommendations used the term “at least,” no clear evidence exists that pushing faster than 100 compressions per minutes or deeper than 5 cm is associated with better or worse outcomes.

The European Resuscitation Council (ERC) published its updated guidelines at the same time and stressed the importance of feedback to rescuers in maintaining high quality CPR.3 The council acknowledged …