Monday, March 26, 2018


In August of 2017 the AHA announced new equipment requirements in order to teach CPR certification courses starting January 31, 2019. In a nutshell, in order to be compliant, an instructor needs to use an instrumented directive feedback device. The AHA defines these devices this way:
An instrumented directive feedback device measures compression rate, depth, hand position, recoil, and chest compression fraction and provides real-time audio or visual feedback (or both) on these critical CPR skills. A feedback device can be integrated into a manikin or serve as an accessory to a manikin.”
In another article, it was more clearly stated the devices “must, at a minimum, measure and provide real-time audio and/or visual feedback on compression rate and depth, allowing students to self-correct or validate their skill performance immediately during training.”


So far the AHA has not given clear direction on the number of manikins required per instructor. Questions remain about whether or not an instructor can have one feedback device to use strictly for the skills test portion of training, or whether all practice performed in the class must be done on a feedback device. It has been touched upon in an FAQ to AHA Instructors:
Q: What is the recommended ratio of feedback devices or manikins a Training Center must have in adult CPR training courses?
A: The recommended ratio of feedback devices is one per manikin (unless the device used is a manikin itself). Please note that any change to the ratio of manikins per students or Instructors in a course agenda could increase or decrease the length of the course. Use of feedback devices may actually reduce practice time as students will be able to self-correct as feedback is provided in real time.”
As of the publication of this article, the new requirement only affects Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), ACLS for Experienced Providers and Heartsaver® adult CPR training courses in the US and internationally. The new requirements do not include child and infant CPR certification at this time; however, it is anticipated those requirements will also be included over time.  


Since certification classes require rescue breath training, instructors will still need to have a manikin which allows rescue breath training. There are many manikins on the market right now which have feedback devices already and would satisfy the requirement, from full-sized full trauma manikins to torso-only manikins and everything in between. Several manufacturers also offer feedback infant and child manikins as well.
External devices which either sit on top of the manikin’s sternum or can be placed under the “skin” of the manikin are also acceptable.
The AHA does not endorse any particular brand or type of device.


Back in 2015, when the new AHA guidelines for quality CPR were announced, the findings from the research which went into the changes also included information on the more accessible feedback devices being used in some training classes and the impact it had on skills retention. They found students trained with these devices were able to self-correct during training, which gave them longer periods of training at the correct rate and depth. This translated into better CPR performed in an emergency situation.