EFFECTIVENESS OF METRONOME USE DURING CARDIOPULMONARY RESUSCITATION ON MANIKIN

Introduction: Importance of effective chest compression during cardio pulmonary resuscitation has been emphasized on the latest AHA guideline but standardization of effective chest compression still remains to be a controversy . On the other hand effects of fatigue on basic life support (BLS) remains to be another argument . In our study we aimed to address if number of cardiac compressions and depth could be standardized on cardiac arrest patients , and show the effects of practitioner fatigue with guidance of metronome on models during BLS . Method: 40 healthcare workers who has BLS education were enrolled in our study. All enrolled personnel was instructed to apply 5 cycles of 2 minute cardio pulmonary resuscitation (CPR) as mentioned in AHA guideline. Practitioners were allowed to rest 2 minutes after each cycle. At least 1 day after the first application each practitioner was instructed to apply another 5 cycles of 2 minute BLS under the guidance of a 100/min metronome and rest 2 minutes after each cycle . Data related to practitioners’ fatigue, number and depth of compressions were recorded for each 2 minute cycle and mean values were calculated . Fatigue was evaluated with a specially designed face scale. Statistical analyses were done by Mann - Whitney U, chi square and T tests, and p values less than 0.05 was accepted to be significant . Findings: The average number of chest compressions recorded for 40 manual and 40 metronome guided BLS groups were found to be 130/min and 103.405/min respectively . Average compression count was found to be statistically significantly higher in manual BSL group (p<0.001) . The average depths of compression was 55.5 and 50.3 respectively in each group and this value was statistically significantly higher in manual BLS group (p<0.001). Average rate of fatigue was found to be statistically significantly higher in manual BLS group after application, 3.9 (very tired) and 2.6 (slightly tired) respectively (p<0.001). Raise in the number of compressions was found to be correlated with the depth of the compression (p=0.026) . Results: As a result of our study; BLS under the guidance of metronome could standardized rate of compression and decrease the fatigue of the practitioner. Although it decreases the compression depth, still meets the requirements on AHA guideline. Under the influence of our results, we believe that use of metronome should be included in BLS application. We also believe that further studies are needed to back up our data