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Effects of flashlight guidance on chest compression performance in cardiopulmonary resuscitation in a noisy environment
  1. Je Sung You1,
  2. Sung Phil Chung1,
  3. Chul Ho Chang2,
  4. Incheol Park1,
  5. Hye Sun Lee3,
  6. SeungHo Kim1,
  7. Hahn Shick Lee1
  1. 1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  2. 2Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Incheol Park, Department of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Republic of Korea; incheol{at}


Background In real cardiopulmonary resuscitation (CPR), noise can arise from instructional voices and environmental sounds in places such as a battlefield and industrial and high-traffic areas. A feedback device using a flashing light was designed to overcome noise-induced stimulus saturation during CPR. This study was conducted to determine whether ‘flashlight’ guidance influences CPR performance in a simulated noisy setting.

Materials and methods We recruited 30 senior medical students with no previous experience of using flashlight-guided CPR to participate in this prospective, simulation-based, crossover study. The experiment was conducted in a simulated noisy situation using a cardiac arrest model without ventilation. Noise such as patrol car and fire engine sirens was artificially generated. The flashlight guidance device emitted light pulses at the rate of 100 flashes/min. Participants also received instructions to achieve the desired rate of 100 compressions/min. CPR performances were recorded with a Resusci Anne mannequin with a computer skill-reporting system.

Results There were significant differences between the control and flashlight groups in mean compression rate (MCR), MCR/min and visual analogue scale. However, there were no significant differences in correct compression depth, mean compression depth, correct hand position, and correctly released compression. The flashlight group constantly maintained the pace at the desired 100 compressions/min. Furthermore, the flashlight group had a tendency to keep the MCR constant, whereas the control group had a tendency to decrease it after 60 s.

Conclusion Flashlight-guided CPR is particularly advantageous for maintaining a desired MCR during hands-only CPR in noisy environments, where metronome pacing might not be clearly heard.

  • Cardiopulmonary resuscitation
  • chest compression
  • flashlight
  • noise
  • stroke
  • imaging
  • CT/MRI
  • ultrasound
  • trauma
  • acute coronary syndrome
  • airway
  • anaesthesia—general
  • emergency care systems

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  • Funding This study was supported by a faculty research grant to Yonsei University College of Medicine for 2011(6-2011-0124).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Yonsei University College of Medicine, Severance Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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