Comparison between music, metronome and metronome superimposed on music in teaching effective cardiopulmonary resuscitation: a prospective interventional study.

Primary objective: To compare difference in appropriate chest compression rate amongst the lay persons trained with music, metronome and metronome superimposed on music immediately post training.

Secondary objective: To compare difference in appropriate chest compression rate amongst the lay persons trained with music, metronome and metronome superimposed on music at 6 weeks post training.

Methodology: Participants fulfilling the inclusion criteria ( lay persons between 18-60 years age group ) and exclusion criteria (healthcare professionals, significant primary or secondary hearing impairment-as reported by subject, prior formal CPR training < 5 years ) will be recruited after informed consent. The centre for Cardiac Arrest and Education (CARE) routinely conducts 1-2 hands only CPR training per month in the community for lay persons (non healthcare providers). During these programmes participants will be enrolled. All participants will be trained for a two-hour session by AHA certified BLS instructors using a combination of didactic instructions and hands on CPR practice using mannequins.

A pretest with questions related to knowledge of CPR will be given using google form.

The participants will be randomly assigned to 3 groups by computer generated randomization.

Group 1 (Metronome group): this group will have a metronome playing in the background with a precise tempo of 110 beats per minute.

Group 2 (Music group): this group will have a standard song – staying alive (By Bee Jees) with beats of 104 per minute or Zinda (By Shankar Ehsaan Loy) with beats of 109 per minute. Among these two, song will be chosen as per familiarity of the majority of the population.

Group 3 (Metronome superimposed on music group): this group will have the metronome superimposed on the music during the training.

All participants will then practice in their respective groups for 1 minute CPR cycles atleast three times.

For each of the groups a CPR instructor will verbally review the correct rate and depth of compressions and intervene/provide feedback if required to maintain the quality of CPR.

Assessment of all participants will be done at the end of training session for 1 minute using QCPR app on mannequin without any auditory prompts. During the final 1-minute analysis no feedback will be provided to participants. QCPR app will assess average rate, depth, chest recoil and provide a CPR score which is a composite of all the above.

Subjective experiences of the participants will be assessed using a standard questionnaire with Likert scale.

A posttest with questions related to knowledge of CPR will be given using google form. In the music group an additional question regarding familiarity with the song will be asked.

Certificates will be provided to all the participants on completion of training.