Accuracy of a feedback device for cardiopulmonary resuscitation on a dental chair

Background Conflicting studies exist about the effectiveness of cardiopulmonary resuscitation (CPR) on a dental chair. In some situations, dental surgeons are obliged to perform CPR with the patient on the chair. Feedback devices are supposed to guide the compression depth in order to improve the quality of CPR, but some devices are based on an accelerometer that can theoretically report erroneous results because of the lack of rigidity of a dental chair. Objective The aim of this study was to evaluate the accuracy of these devices to guide chest compressions on a dental chair. Methods A prospective, randomised, crossover, equivalence/non-inferiority study was conducted to compare the values of compression depths provided by the feedback device (Real CPR Help (R), delivered by Zoll (c) Medical Corporation, Chelmsford, MA, USA) with the real measurements provided by the manikin (Resusci Anne (R) Advanced SkillTrainer, Laerdal Medical AS (c), Norway). Chest-compression-only CPR was performed by 15 Basic Life Support instructors who carried out two rounds of continuous CPR for 2 min each. Data were analysed with a correlation test, a Bland-Altman method and a Wilcoxon test. Statistical significance was defined as p<0.05. Results A significant difference was found between the mean depths of compression measured by the feedback device and the manikin on a dental chair and on the floor (p<0.0001). The feedback device overestimated the depth of chest compressions, and Bland-Altman analysis demonstrated poor agreement. Conclusion This study indicates that feedback devices with accelerometer technology are not sufficiently reliable to ensure adequate chest compression on dental chairs.