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Pit Crew Approach with Real-Time CPR Feedback Saves Lives

WASHINGTON, Feb. 28, 2013 /PRNewswire/ -- Cardiopulmonary resuscitation (CPR) training that included real-time audiovisual feedback and that emphasized a "pit crew" or team approach to pre-hospital care for cardiac arrest patients increased survival by almost 60 percent.  The results of a clinical trial of scenario-based training were published online yesterday in Annals of Emergency Medicine ("The Influence of Scenario-Based Training and Real-Time Audiovisual Feedback on Pre-hospital Cardiopulmonary Resuscitation Quality and Survival from Out-of-Hospital Cardiac Arrest")


"Ours is the first study to demonstrate an association between a dedicated CPR quality initiative using real-time audiovisual feedback and out-of-hospital cardiac arrest outcomes," said lead study author Bentley Bobrow , MD, FACEP of The University of Arizona College of Medicine in Phoenix, Ariz. "It is also the first to show an association between performance of the 2010 American Heart Association CPR quality metrics and increased survival for out-of-hospital cardiac arrest."

The Mesa Fire and Medical Department in Mesa, Arizona implemented 2 hours of didactic teaching, 2 hours of scenario-based training and activation of real-time audiovisual feedback.  Training emphasized a team approach to resuscitation, assigning each member of the team a role in a "'pit crew' model of resuscitation."

CPR quality measures improved significantly after the training protocol was established. Chest compressions decreased from 128 to 106 per minute. Chest compression depth increased from 1.78 to 2.15 inches. Other measures improved similarly. Survival for all groups increased from 8.7 percent to 13.9 percent. For patients with shockable rhythms whose arrest was witnessed, survival more than doubled, from 26.3 percent to 55.6 percent.

"A carefully targeted CPR training curriculum that included real-time audiovisual feedback helped our EMS system significantly improve survival from cardiac arrest in just 18 months," said Dr. Bobrow.  "This is very encouraging news for all communities trying to tackle the major public health problem of out-of-hospital cardiac arrest. This intervention is feasible on a large scale and has the potential to save thousands of lives every year."

For video demonstration of the CPR protocol, visit:

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit

Related Links:
Emergency medicine resources
CPR: Video Demonstration

SOURCE American College of Emergency Physicians (ACEP)
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