Listening to repeated choruses of Disco Science can improve the rate of chest compressions in subjects carrying out cardiopulmonary resuscitation (CPR) but does not help to achieve the correct depth of compressions, a study has found.

Anyone who has performed chest compressions either in a real life or a simulated situation will know that it is hard work. The current Resuscitation Council (UK) 2010 adult basic life support guidelines indicate that the chest should be compressed to a depth of 5 to 6 cm at a rate of 100 to 120 compressions per minute. This is often done badly even by trained healthcare professionals. A recent study in the Emergency Medicine Journal assessed the role of music as a training aid.

This is not a new concept with previous recommendations for the Bee Gees’ song Stayin’ Alive in the United States and Nellie the Elephant in the UK. However, while these have been shown to help maintain the correct rate they do not seem to help to provide the right compression depth. The authors therefore compared Achy Breaky Heart sung by

Billy Ray Cyrus and Disco Science by Mirwais with no music to see if they could improve on the previous findings. Would a more pronounced beat make a difference? The songs were edited to ensure that the relevant parts were repeated for an appropriate interval.

The study was a randomised crossover design which recruited 74 delegates (37 male) attending an Australian College of Ambulance Professionals conference in Auckland, New Zealand.

Delegates performed three one-minute sequences of continuous chest compressions on a dummy accompanied by no music, repeated choruses of Achy Breaky Heart or Disco Science. Overall, 61% of the participants were paramedics, 20% students and 19% ‘other’ healthcare professionals. Just over half (54%) had received CPR training within the previous year.

Significantly more delegates maintained compressions within the optimal range of 100 to 120 compressions a minute when listening to Disco Science than when listening to Achy Breaky Heart (82% vs 64%, p=0.07). Achy Breaky was no better than no music (64% vs 65%).

However, compressions were still too shallow irrespective of the background music; 39% at the correct depth with Disco Science, 43% with Achy Breaky and 42% with no music.

Furthermore, incorrect hand positioning was rife and seen in up to two thirds of delegates. The authors were therefore unconvinced that music provides any benefit in improving the quality of CPR compared with a metronome or audible feedback. Time to abandon iPod augmented CPR then!

Dr Peter Savill

• Woollard M, Poposki J, McWhinnie B et al. Achy breaky makey wakey heart? A randomised crossover trial of musical prompts. Emerg Med J. Online First 2011. doi10.1136/emermed-2011-200187