Effectiveness of infrared thermography in monitoring ventilation performance during cardiopulmonary resuscitation training: A cross-sectional simulation study in nursing students

Providing reliable systems to assess ventilation outcomes in simulation-based scenarios is paramount to improve the performance during cardiopulmonary resuscitation (CPR) in real situations. The aim of this study is to investigate the reliability of infrared thermography (IRT) in monitoring the quality of resuscitative breaths in undergraduate nursing students during a simulated CPR-based clinical practice. We recruited a convenience sample of 21 volunteer students in the second year of the Bachelor of Nursing. Participants were instructed to perform CPR following the European Resuscitation Council guidelines in training manikins from Laerdal Medical® during two consecutive minutes. Demographic and knowledge data about CPR performance were collected with a questionnaire whilst ventilation quality parameters (volume, rate, time spent) were provided by the manikin software. Thermographic images from the manikin's peripheral mouth region were recorded at the end of each CPR ventilation cycle. The temperature profile was examined at baseline and after 1 and 2 minutes of ventilation performance. A temperture increment of 1.357 ºC was observed when comparing the maximum temperature at minute 1 with regard to baseline, whilst a significative decrease was obtained between minute 1 and minute 2 (0.457ºC) of the study. The comparison between the number of ventilations and the temperature variation after 1 minute of CPR training produced good correlation values (rho = 0.658, p=0.0019). A positive association was also observed between IRT and t ventilation volume values (r = 0.503, p=0.02). Our results indicate that infrared thermography is a promising tool for assessing ventilation performance in CPR practice, thus enabling its potential use as predictor of the quality of resuscitative breaths in simulation-based scenarios.