Evaluation: Zoll Real CPR Help CPR Feedback Device

January 8, 2016 | Evaluations & Guidance


  • Real CPR Help consists of software incorporated into a defibrillator and a disposable sensor ("puck") integrated into CPR-compatible defibrillation electrodes. When the electrodes are placed properly, the sensor is positioned on the patient's sternum. Real CPR Help is standard on all of Zoll's professional defibrillators and AEDs:
    • R Series monitor/defibrillators
    • X Series monitor/defibrillators
    • M Series monitor/defibrillators
    • E Series monitor/defibrillators
    • AED Plus
    • AED Pro
  • Real CPR Help provides real-time feedback to CPR providers on four of the five key parameters of high-quality CPR (as specified in AHA guidelines):
    • Compression depth
    • Compression rate
    • Chest wall recoil
    • Inactivity time
  • Real CPR Help does not provide feedback on the fifth parameter: ventilation.
  • The device is intended for clinical use, but can be used with training electrodes and a CPR simulator for CPR training on manikins.
  • The device also provides CPR data for postevent review.
    • CPR data is integrated directly into the monitor/defibrillator or AED event data; a report of CPR performance can be generated.
    • Audio recording is available on some AEDs and monitor/defibrillators for later event review.
  • Components and capabilities:
    • Feedback on compressions is provided through use of a chest sensor that is connected to defibrillation electrodes.
      • The sensor on the CPR electrodes uses an accelerometer to measure compression depth and chest wall recoil, as well as to calculate compression rate.
      • The chest sensor is an oval measuring 4 × 2.5 × 0.5 inches (H × W × D) and is adhered to the sternal electrode. The electrode shows a diagram of proper electrode and sensor placement.
      • The sensor connects to the monitor/defibrillator or AED via the defibrillation cable. The defibrillator powers Real CPR Help.
    • When Real CPR Help is used with a monitor/defibrillator, CPR feedback is displayed in a CPR dashboard on the monitor/defibrillator screen:
      • Compression bars (a graphical representation of compression rate and depth)
      • Numerical compression rate
      • Numerical compression depth
      • Chest wall recoil
      • Zoll's perfusion performance indicator (PPI)—a diamond that fills up when CPR is performed according to the guidelines, providing a quick overview of CPR performance
    • The chest sensor also enables See-Thru CPR, a capability that filters chest compressions out of the ECG waveform on the display of monitor/defibrillators or the AED Pro, allowing the resuscitation team to see the heart rhythm while CPR is being performed. Zoll recommends that users pause CPR to confirm the heart rhythm prior to defibrillation.
  • Use limitations (per the manufacturer's instructions for use):
    • Real CPR Help is indicated for use on adult patients and, when used with compatible pediatric CPR electrodes, pediatric patients. When pediatric electrodes are used, Real CPR Help enables compression rate and depth measurements only, not guidance or verbal feedback regarding effective CPR, since the recommended compression depth varies based on patient size.
    • Real CPR Help is not intended for use in a moving environment, such as an ambulance or an ascending or descending aircraft.

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