Impact of High Fidelity Simulation Training on the Quality of Cardiopulmonary Resuscitation Performance among Emergency Medical Services (EMS) Professionals in Pune, India

Abstract

Introduction: The provision of high quality cardio pulmonary resuscitation (CPR) is a key modifiable
factor associated with survival in cardiac arrest. Management of a patient with cardiac arrest is a dynamic
and high-pressure challenge requiring critical decision making in a short period of time. Numerous studies
emphasize that quality of chest compressions directly influences survival rate from cardiac arrest. Hence,
improving CPR quality is of paramount importance. This can be achieved by accurate measurement of
various CPR metrics and provision of real time feedback to the rescuer.
Objective: The study aims to assess impact of high fidelity simulation training on quality of CPR performance
of EMS Professionals.
Methods: A high fidelity manikin was utilized to create four unique healthcare simulation scenarios based on
cardiac arrest. The manikin software was capable of capturing real-time CPR data and measured parameters
like chest compression depth (CCD), chest compression rate (CCR), chest recoil (CR) and chest compression
fraction (CCF). The participants were initially taught the assessment and management of cardiac arrest. The
participants underwent a pre-intervention test conducted on high fidelity manikin. The CPR metrics were
recorded during the session. The participants were then imparted training with real time CPR feedback for a
period of two months. This was followed by a post-intervention test and the CPR metrics of both tests were
compared.
Discussion: The participants showed improvement in chest compression depth and chest compression rate
but the chest recoil frequency and chest compression fraction decreased after the two-month intervention
period. The overemphasis on achieving target depth and rate led to ignorance of the other two parameters
affecting overall quality of CPR.
Conclusion: Maintaining adequate attention on all aspects of CPR metrics is a complex challenge even for
trained professionals. Utilizing technology for real-time feedback is a reliable method to gauge improvement
in quality of CPR during training sessions of EMS professionals.