Are emergency mnemonics help(err)ful?

14343115539_34e258f817If I was giving out awards for my favourite titles for research articles, a 2014 paper by Roehr et al would almost certainly be on my shortlist.  These researchers not only impressed me by managing to mention ABBA in the title of their paper, but for carrying out one of those research studies that might truly be helpful in practice. The gist of their findings is that, although more research is needed, ABBA’s ‘SOS’ was the only one of five songs that seemed to help practitioners co-ordinate chest compressions and inflations while attempting to resuscitate a doll.  Good news, because mnemonics and tricks like this are really helpful for some people.

I’ve had to hang onto this thought for a good few weeks, though, as Roehr et al’s (2014) paper (whose abstract is below if you want to read it) was the perfect study to share with you alongside my Practising Midwife article from October 2014, which I have uploaded for your perusal today.  My article is called ‘Are emergency mnemonics help(err)ful‘ and in it I have looked at another study evaluating how well midwives and doctors remember the mnemonics that are now commonly used in the teaching of emergency skills and drills.  As a long-time student and teacher of different ways of knowing, thinking and learning, I wanted to raise a few questions about mnemonics, and that’s just what I’ve done in this article.

Since this was published, I haven’t needed to give manual inflations to a newborn baby, so I can’t yet report on whether I felt my singing enhanced or detracted from their experience of resuscitation.  Or what their parents thought about this, which is another important question.  I may have tested it on a Baby Anne though, just to make sure I’m in good voice the next time I need to do it for real…   If you need a bit of practice and it’s been a while, here’s a link to SOS online!

 

The Research

AIM: Resuscitation guidelines recommend 90 chest compressions (CCs) and 30 inflations (INFs) per minute for neonatal cardiopulmonary resuscitation (nCPR). We hypothesised that auditory prompts would help coordinate these actions. Our aim was to investigate the effect of musical prompts during nCPR training on adherence to recommended CC and INF rates and on the quality of delivered INFs.

METHODS: A simulation study was conducted employing 30 experienced neonatal staff, a respiratory function monitor and a neonatal manikin. The effects of five different auditory prompts on adherence to recommended rates of CC and INF were tested against baseline (no music). The five auditory prompts (popular musical tunes) were investigated in random order. Quality of INFs was assessed by comparing the peak inflation pressures (PIP), positive end-expiratory pressures (PEEP), percentage mask leak and tidal volumes (VT).

RESULTS: Mean baseline rates at which CCs and INFs were delivered were 80 (SD 6) per minute and 28 (SD 2) per minute, respectively. Listening to auditory prompts had varying effects on CC and INF delivery rates. For CCs, a significant difference to baseline was found only when participants listened to ABBA’s ‘SOS’, with 86 (SD 7) per minute (P = 0.04). For INFs, we found a statistically significant improvement to baseline rate only for ‘SOS’, with 29 (SD 2) per minute (P = 0.04), and there was no significant difference in INF quality among the auditory prompts.

CONCLUSIONS: Musical prompts can help with adherence to recommended CC and INF rates but do not improve the quality of INFs during nCPR training. The lasting effect of auditory prompts as musical mnemonics on nCPR performance in vivo needs to be established.

 

Roehr CC; Schmlzer GM; Thio M; et al, (2014). How ABBA may help improve neonatal resuscitation training: Auditory prompts to enable coordination of manual inflations and chest compressions. Journal of Paediatrics and Child Health , vol 50, no 6, 2014, pp 444-448.

 
photo credit: P2720654 via photopin (license)

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