Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

Elise Zimmerman, Naiomi Cohen, Vincenzo Maniaci, Barbara Pena, Juan Manuel Lozano, Marc Linares

Pediatrics, 2015

Links   PubMed   Pediatrics  pdf


The Bottom Line

Using a metronome during CPR may help chest compressors maintain their rate.

What They Did

  • The investigators conducted a prospective crossover randomized controlled trial of pediatric residents, fellows, nurses, and medical students who they randomly assigned to do chest compressions on a mannikin with and without a metronome
  • The metronome sounded at a rate of 100 times per minute
  • The investigators also piped in “background noise”
  • Each participant did 2-minutes of CPR, twice with a 15-minute break in between cycles. One group had metronome first, the other metronome second.
  • The CPR rate and depth were recorded electronically via the ResusciAnne Wireless SkillReporter software
  • Metronome on 72% adequate rate (90-100 compressions/minute)  vs 50% off (95% CI, 15% to 29%)
  • No significant difference was noted in the mean percentage of compressions within acceptable depth (38–51 mm)
  • Interestingly the metronome had a larger effect amongst med students, residents and fellows as opposed to the pediatric nurses

What You Can Do

  • This is one of those “so simple why didn’t I think of it” ideas
  • Go ahead and try using a metronome the next time you run a sim or practice CPR. Maybe you even bring one into your resuscitation area?
  • The reason why PALS teachers recommended “listening to” Stayin’ Alive by the Bee Gees is that the song is 103 beats per minute. Interestingly a study from 2011 looked at compression rates while CPR participants listen to either “Achy Breaky Heart,” “Disco Science” or no music at all.

Listening to DS significantly increased the proportion of prehospital professionals compressing at 2010 guideline-compliant rates. Regardless of intervention more than half gave compressions that were too shallow. Alternative audible feedback mechanisms may be more effective.