Home › Cardiac arrest › Defining quality in bystander CPR

Cardiac arrest

Defining quality in bystander CPR

Development of a quality metric to measure bystander cardiopulmonary resuscitation in out of hospital cardiac arrest: A modified Delphi study
International Journal of Nursing Studies Advances · 2026-10-17 · Added 2 November 2026

A UK-led modified Delphi study with an international panel of doctors, paramedics, nurses and laypersons reached consensus on 11 dichotomous indicators — compression rate, depth and recoil plus dispatcher instruction, time from recognition to emergency call and AED use — to measure bystander CPR quality in OHCA.

Study type

Guideline / statement

Design

Modified Delphi consensus study (two survey rounds plus a virtual consensus meeting)

Participants

104 panellists registered; 62, 48 and 18 completed rounds 1–3

Main finding

Consensus (≥75% agreement) on 11 indicators covering chest compression rate, depth and recoil and contextual factors including dispatcher instruction, time from recognition to emergency call and AED use; two composite indicators were created and all criteria scored dichotomously.

Caveat

The metric is provisional and unvalidated, and panel attrition left only 18 participants in the final consensus round.

Bottom line

Context only

Learning goal

Understand how bystander CPR quality indicators can inform community responder and dispatcher practice in cardiac arrest care.

More

• Topic: Cardiac arrest
• Daily scan: 2 November 2026
• Podcast: Paramedic Papers Daily, 2 November 2026

Related papers on Cardiac arrest

• Bystanders describe heavy emotional toll of doing CPR

  Resuscitation Plus · 1 Nov 2026 · Qualitative · Hypothesis-generating

  A Scottish qualitative study of 11 bystanders who performed CPR in an OHCA found a substantial emotional impact — worst when the patient died or was known to them — with themes of being compelled to help but unprepared, and identified better emotional preparation in CPR training and access to a knowledgeable independent person as ways to reduce it.

• Nursing-home arrests more often shockable, linked to early AED

  Resuscitation Plus · 1 Nov 2026 · Registry · Hypothesis-generating

  A Japanese population-based registry of 2,478 medical-origin OHCA cases found an initial shockable rhythm in 36.3% of nursing-home arrests versus 7.1% at home (adjusted OR 12.35), with 97% of shockable nursing-home patients receiving an AED shock but only 0.8% surviving with good neurological outcome.

• Real-time BVM feedback linked to better arrest ventilation

  Resuscitation · 31 Oct 2026 · Cohort · Hypothesis-generating

  A US prospective before/after study in Milwaukee found real-time BVM feedback (Real BVM Help) was associated with the share of OHCA ventilations meeting both rate and tidal-volume targets rising from 7.5% to 39.0%.

• ECG signs appear minutes before post-ROSC rearrest

  Resuscitation · 31 Oct 2026 · Cohort · Hypothesis-generating

  A US retrospective cohort of 1,298 post-ROSC OHCA patients found routine ECG features — wider QRS, lower heart rate, higher heart-rate variability — were associated with rearrest, with prediction best one minute before it (AUROC 0.74).