Aims Current International Liaison Committee on Resuscitation (ILCOR) guidelines emphasise the provision of high quality chest compressions during infant cardiopulmonary resuscitation (CPR). Recent research, however, reports that <1% of all chest compressions achieve all four internationally recommended quality targets during simulated infant CPR. This study aimed to determine if ‘real-time performance feedback’ improved the quality of chest compressions provided during simulated infant CPR.

Methods Sixty-nine certified European and Advanced Paediatric Life Support (EPLS and APLS) training course instructors were recruited from seven EPLS/APLS training courses. Instructors were randomly allocated to either a ‘no-feedback’ or ‘feedback’ group, and performed 60 seconds of two-thumb (TT) and two-finger (TF) chest compressions on a “physiological” CPR manikin instrumented to measure chest deflections. Baseline data were recorded for both groups without feedback, before chest compressions were repeated in the experimental phase with the ‘feedback’ group receiving real-time performance feedback. Chest compression depths, chest release forces, chest compression rates and compression duty cycles were recorded for all participants. Quality indices were calculated to report the proportion of chest compressions that achieved internationally recommended quality targets for each measure, with an overall quality index calculated to report the proportion of chest compressions that simultaneously achieved all four quality targets. Results were compared between the ‘no-feedback’ and ‘feedback’ groups.

Results Baseline data were consistent with other studies, with < % of chest compressions simultaneously achieving all four internationally recommended quality targets. During the experimental stage (Table 1), the provision of real-time performance feedback improved the quality of the chest compression depths, chest compression rates and compression duty cycles provided by both techniques (all measures: p < 0.001). This enabled the ‘feedback’ group to simultaneously achieve all four quality targets in 75% of TF and 80% of TT technique chest compressions, whilst <1% of chest compressions achieved this for the ‘no-feedback’ group.

Conclusions Real-time performance feedback considerably increased the quality of chest compressions provided during simulated infant CPR. If these results transfer into clinical practise this technology could, for the first time, support resuscitators in performing high quality chest compressions during infant CPR and thus potentially improve future outcomes.