Purpose of the study: Outcome of cardiopulmonary ventilation (CPR) may be improved by better education and training, including measurement of process parameters. Software CODE STAT for Lifepack monitors allows to evaluate the real course of CPR performed by ambulance staff. Parameters like time to the first analysis, compressions rate, hands-on-time, pre- and post-defibrillation pause, ratio of compressions and ventilation, duration of CPR can be measured and evaluated. Capnography readings also provide valuable indications of quality of CPR. These parameters can be used for evaluation of the real course of CPR, for giving specific feedback to the staff and looking for the better outcome after personalized education.  
Materials and methods: All patients with out-of-hospital-cardiac-arrest (OHCA) with fibrillation rhythm in region Zilina seen by Falck Zachranna ambulance staff from 1.7.2014 to 31.12.2016. After introduction of CODE STAT in august 2015 the course of real CPR was evaluated by the first author, feedback was sent to the staff with individual retraining. Outcome for return of spontaneous circulation (ROSC) and 30-days survival before and after change was compared. 
Results: In 668 OHCA patients CPR was attempted in 311. ROSC was obtained in 101 (32%). Measurements of real CPR process parameters showed larger variability then in testing on manekin.  In 84 patients with initial shockable rhythm (26%) there was 54% vs 70% of ROSC and 27% vs 33% 30-days survival before and after intervention, respectively. This difference was not significant in ANOVA and Pearson correlation test. 
Conclusions: After introduction of CODE STAT detailed analysis with feedback for the staff we observed better outcome in ROSC and survival, but the differences in this small group were not significant. We believe that this time demanding sophisticated approach still may be useful in improving outcome of cardiac arrest patients.

Improvement of CPR outcome by CODE STAT feedback system in Falck Zachranna