By Tracey Barron
This past April, 80 students from a Salt Lake City, Utah, area high school received a lesson to save lives during a study conducted by the International Academies of Emergency Dispatch (IAED) research team and facilitated by high school health teacher Myriah Fankhauser.
Students from Fankhauser’s four health classes assembled in the study area at the same times the classes regularly met. The approximately 20 students from each class took a number from a box indicating whether they would be part of the control or experimental group. They were individually sent to either of two separate spaces on either side of the larger room where a member of the IAED research team read the scripted message: You have walked into a room and found the person unconscious on the floor. Pretend you are calling 911. Wait for the Emergency Medical Dispatcher to pick up the phone. Answer the EMD’s questions and follow the instructions.
EMDs Holly Downs and Leslie Devey, both from Valley Emergency Communications Center (VECC), in Salt Lake County, sat stationed at mock CADs set up outside the study area, going through Case Entry and providing Pre-Arrival Instructions subsequent to identifying the patient as “unconscious and not breathing” following Case Entry Question 6.
Students, kneeling alongside the lifesaving dummies, gave chest compressions for timed two-minute periods. In the experimental group, students and the EMD counted out loud using a metronome, while in the control group, students and the EMD counted out loud without the use of a metronome. The study will compare the efficiency of chest compressions when administered with and without the metronome.
According to several studies, a metronome, commonly used by musicians to maintain a beat, can enhance the efficiency of CPR and, consequently, improve a patient’s survival rate. In a similar study, more than 150 medical providers performed two rounds of chest compressions on a pediatric mannequin, one round with the metronome and one without. It turned out the metronome provided significant improvement in the mean percentage of compressions delivered within an adequate rate (90–100 compressions per minute).1
A metronome audio is built into the Medical Priority Dispatch System (MPDS) ProQA software; every click of the metronome signals the rescuer to do a chest compression.
The IAED research team is taking the study to several other locations, with varied demographics, to determine the efficacy of metronomes in giving chest compressions. Other study goals might include the necessity of a scripted message telling the caller to put the phone on speaker and lay it beside the patient prior to beginning CPR. As clearly indicated at the high school trial, positioning of the cellphone under the chin or holding it in one hand, while pumping with the other, compromised compressions.
Interviewed students had little to no experience giving CPR. A few of the students had taken a lifesaving course that included CPR in preparation for summer jobs at the local recreation pools or to babysit. The physical exertion of effective CPR surprised several students, although one student said experience from pushing a marimba (a percussion instrument) in the school’s marching band definitely benefitted her stamina at giving chest compressions.
Finally, the study alerted students to the importance of knowing how to perform effective CPR and the importance of following an EMD’s instructions during an emergency situation.
“It was a cool study,” said freshman Ethan Fender, who is thinking about becoming a paramedic. “I doubt kids our age know how to talk to a dispatcher. I don’t think many of us knew that a dispatcher gave instructions.”
Fankhauser welcomed the study as part of her goal to encourage certification in CPR.
1 Zimmerman E, Cohen N, Maniaci V, Pena B, Lozano J, Linares M. “Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study.” Pediatrics. 2015; November. http://pediatrics.aappublications.org/content/136/5/905 (accessed May 16, 2016).