Survival after traumatic cardiac arrest is possible-a comparison of German patient-registries.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) due to trauma is rare, and survival in this group is infrequent. Over the last decades, several new procedures have been implemented to increase survival, and a "Special circumstances chapter" was included in the European Resuscitation Council (ERC) guidelines in 2015. This article analysed outcomes after traumatic cardiac arrest in Germany using data from the German Resuscitation Registry (GRR) and the TraumaRegister DGU® (TR-DGU) of the German Trauma Society.  METHODS: In this study, data from patients with OHCA between 01.01.2014 and 31.12.2019 secondary to major trauma and where cardiopulmonary resuscitation (CPR) was started were eligible for inclusion. Endpoints were return of spontaneous circulation (ROSC), hospital admission with ROSC and survival to hospital discharge. RESULTS: 1.049 patients were eligible for inclusion. ROSC was achieved in 28.7% of the patients, 240 patients (22.9%) were admitted to hospital with ROSC and 147 (14.0%) with ongoing CPR. 643 (67.8%) patients were declared dead on scene. Of all patients resuscitated after traumatic OHCA, 27.3% (259) died in hospital. The overall mortality was 95.0% and 5.0% survived to hospital discharge (47). In a multivariate logistic regression analysis; age, sex, injury severity score (ISS), head injury, found in cardiac arrest, shock on admission, blood transfusion, CPR in emergency room (ER), emergency surgery and initial electrocardiogram (ECG), were independent predictors of mortality. CONCLUSION: Traumatic cardiac arrest was an infrequent event with low overall survival. The mortality has remained unchanged over the last decades in Germany. Additional efforts are necessary to identify reversible cardiac arrest causes and provide targeted trauma resuscitation on scene. TRIAL REGISTRATION: DRKS, DRKS-ID DRKS00027944. Retrospectively registered 03/02/2022.

Medical Emergency Datasets Can Improve the Comprehensiveness of Handover Information: A Simulation Study.

Background: Access to patients' medical histories can be of vital importance to ensure proper treatment in an emergency. Germany is planning to introduce a medical emergency dataset (MED), accessible through an electronic health card, and comprising important patient information, such as diagnoses, medications, and allergies. Introduction: This article evaluates the effect of MEDs on the comprehensiveness of a physician's documentation and handover process to the emergency department of a hospital. Materials and Methods: In 2 randomized, crossover simulation studies, 72 emergency physicians participated in 2 emergency scenarios, either with or without access to an MED. Subsequently, they had to document the key information (pre-existing conditions, medications, and allergies) and hand it over to a fictional hospital. The influence of the MED on the documentation of key information was analyzed using the two-sided Prescott's exact test. Sensitivity analyses adjusting for scenario were conducted. Results: The results show that in scenarios with an MED, documentation of key information in the handover process was more complete. In the first trial, 2 of 3 key items (pre-existing conditions/information and allergies) presented a statistically noticeable difference in scenarios with the MED. The second trial confirmed these results for all key items. Discussion: The findings indicate that the use of MEDs in emergency care could be beneficial since documentation and handover in scenarios with an MED were superior to current real-world practices. Conclusions: Access to more complete patient information through an MED could help to improve the patient's treatment.

A better understanding of ambulance personnel's attitude towards real-time resuscitation feedback.

OBJECTIVE: High-quality chest compressions during cardiopulmonary resuscitation (CPR) play a significant role in surviving cardiac arrest. Chest-compression quality can be measured and corrected by real-time CPR feedback devices, which are not yet commonly used. This article looks at the acceptance of such systems in comparison of equipped and unequipped personnel. DESIGN: Two groups of emergency medical services' (EMS) personnel were interviewed using standardized questionnaires. SETTING: The survey was conducted in the German cities Dortmund and Münster. PARTICIPANTS: Overall, 205 persons participated in the survey: 103 paramedics and emergency physicians from the Dortmund fire service and 102 personnel from the Münster service. INTERVENTION: The staff of the Dortmund service were not equipped with real-time feedback systems. The test group of equipped personnel of the ambulance service of Münster Fire brigade uses real-time feedback systems since 2007. MAIN OUTCOME MEASURE: What is the acceptance level of real-time feedback systems? Are there differences between equipped and unequipped personnel? RESULTS: The total sample is receptive towards real-time feedback systems. More than 80% deem the system useful. However, this study revealed concerns and prejudices by unequipped personnel. Negative ratings are significantly lower at the Münster site that is experienced with the use of the real-time feedback system in contrast to the Dortmund site where no such experience exists-the system's use in daily routine results in better evaluation than the expectations of unequipped personnel. CONCLUSIONS: Real-time feedback systems receive overall positive ratings. Prejudices and concerns seem to decrease with continued use of the system.

[Resuscitation - Basic Life Support in adults and application of automatic external defibrillators]. / Reanimation - Basismaßnahmen bei Erwachsenen und Anwendung automatischer externer Defibrillatoren.

Witnesses of a sudden cardiac arrest play a key-role in resuscitation. Lay-persons should therefore be trained to recognize that a collapsed person who is not breathing at all or breathing normally might suffer from cardiac arrest. Information of professional emergency medical staff by lay-persons and their initiation of cardio-pulmonary-resuscitation-measures are of great importance for cardiac-arrest victims. Ambulance-dispatchers have to support lay-rescuers via telephone. This support includes the localisation of the nearest Automatic External Defibrillator (AED). Presentation of agonal breathing or convulsions due to brain-hypoxia need to be recognized as potential early signs of cardiac arrest. In any case of cardiac arrest chest-compressions need to be started. There is insufficiant data to recommend "chest-compression-only"-CPR as being equally sufficient as cardio-pulmonary-resuscitation including ventilation. Rescuers trained in ventilation should therefore combine compressions and ventilations at a 30:2-ratio. Movement of the chest is being used as a sign of sufficient ventilation. High-quality chest-compressions of at least 5 cm of depth, not exceeding 6 cm, are recommended at a ratio of 100-120 chest conpressions/min. Interruption of chest-compression should be avoided. At busy public places AED should be available to enable lay-rescuers to apply early defibrillation.

'Kids save lives': why schoolchildren should train in cardiopulmonary resuscitation.

PURPOSE OF REVIEW: Quick initiation of basic life support (BLS) by laypersons is one of the most successful strategies in the fight against sudden cardiac death. In developed countries, cardiac arrest is still a major contributor to avoidable death, and despite the fact that more than 50% of all cardiac arrests are witnessed, layperson BLS is performed in less than 20%. To improve this situation, BLS training in schools has been established. RECENT FINDINGS: Cardiopulmonary resuscitation (CPR) instruction including the use of automatic external defibrillators (AEDs) has shown to be feasible even for young schoolchildren, and there is an indication that respective programmes are effective to enhance patient outcome on a population basis. Earlier training may even lead to more sustainable results; however, it is reasonable to implement adjusted curricula for different child ages. The programme 'Kids Save Lives' recently endorsed by the WHO will help promoting school-based BLS training worldwide demanding education on CPR for all pupils starting at least at age 12. SUMMARY: Resuscitation training in schools can help to increase the amount of BLS-trained population. Social skills of pupils can be improved and training can be successfully implemented independently of the pupils' age and physique.

A comprehensive assessment of the transcriptome of cork oak (Quercus suber) through EST sequencing.

BACKGROUND: Cork oak (Quercus suber) is one of the rare trees with the ability to produce cork, a material widely used to make wine bottle stoppers, flooring and insulation materials, among many other uses. The molecular mechanisms of cork formation are still poorly understood, in great part due to the difficulty in studying a species with a long life-cycle and for which there is scarce molecular/genomic information. Cork oak forests are of great ecological importance and represent a major economic and social resource in Southern Europe and Northern Africa. However, global warming is threatening the cork oak forests by imposing thermal, hydric and many types of novel biotic stresses. Despite the economic and social value of the Q. suber species, few genomic resources have been developed, useful for biotechnological applications and improved forest management. RESULTS: We generated in excess of 7 million sequence reads, by pyrosequencing 21 normalized cDNA libraries derived from multiple Q. suber tissues and organs, developmental stages and physiological conditions. We deployed a stringent sequence processing and assembly pipeline that resulted in the identification of ~159,000 unigenes. These were annotated according to their similarity to known plant genes, to known Interpro domains, GO classes and E.C. numbers. The phylogenetic extent of this ESTs set was investigated, and we found that cork oak revealed a significant new gene space that is not covered by other model species or EST sequencing projects. The raw data, as well as the full annotated assembly, are now available to the community in a dedicated web portal at http://www.corkoakdb.org. CONCLUSIONS: This genomic resource represents the first trancriptome study in a cork producing species. It can be explored to develop new tools and approaches to understand stress responses and developmental processes in forest trees, as well as the molecular cascades underlying cork differentiation and disease response.

[Impact of the 2020 lockdown on prehospital psychiatric emergencies in a large city]. / Auswirkungen des Lockdowns 2020 auf präklinische psychiatrische Notarzteinsätze in einer Großstadt.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic represented a serious challenge for healthcare systems worldwide. Special psychiatric patients represent a vulnerable group and are particularly affected by lockdown interventions. Knowledge on the possible effects for this group of patients in an emergency physician setting is low. OBJECTIVE: The aim of this paper is to investigate the impact of the first lockdown during the COVID-19 pandemic in 2020 on emergency ambulance services for psychiatric patients in a large German city. MATERIAL AND METHODS: A retrospective analysis was conducted on all prehospital psychiatric emergencies in a large German city during the first pandemic-related lockdown from 22 March 2020 to 4 May 2020, with the same period in 2019 serving as a reference. RESULTS: During the first lockdown there was a significant increase in the number of emergency missions with respect to psychiatric cases. A substantial rise in substance-associated deployments was observed. Moreover, there was an increase in the proportion of psychiatric patients who did not meet emergency criteria. Suicidal tendencies and agitation status played a minor role during the lockdown. CONCLUSION: The lockdown had a notable impact on the frequency and profile of emergency physician calls in the metropolitan area studied. The substantial increase in substance-associated callouts can be interpreted as both a deterioration in access to the healthcare system and an expression of the increased stress faced by the general population and vulnerable groups in particular.

The German Resuscitation Registry - Epidemiological data for out-of-hospital and in-hospital cardiac arrest.

Introduction: The German Resuscitation Registry was started in 2007 and collects data on out-of-hospital as well as in-hospital cardiac arrest and resuscitation. It has collected more than 400.000 datasets till today. Methods: The German Resuscitation Registry (GRR) is a voluntary quality improvement tool and research tool for out-of-hospital and in-hospital resuscitation as well as in-hospital emergency treatment. It collects data for initial treatment, in-hospital care as well as long-term outcome in an online database. For risk stratification two scores have been developed, published, and implemented. The participants are getting annual and monthly or quarterly reports in addition to the standardized online, 24/7 available analyzing options. An annual public report is published as well. We are reporting on the OHCA annual report of 2022. Results: In 2022 the incidence of CPR started or continued by EMS was 77.6/100.000 inhabitants/year. The mean age was 70.2 years and 66.7% were male bystanders who started CPR in 51.3%. The average response time for the first EMS vehicle to arrive on scene was 6:55 min.In 57.9% of the cases, they had a presumed cardiac cause. The primary outcome, return-of-spontaneous circulation (ROSC) was achieved in 42.1%. Discussion: With its more than 450.000 included datasets, the GRR is an established tool for quality improvement and research in Germany and internationally. The results for the incidence of OHCA and outcome from 2022 are compared to EuReCa TWO data ranging in the upper third of European countries. Furthermore, the GRR has contributed to increasing knowledge of OHCA by conducting and publishing research e.g. on epidemiology, airway management, and medication of OHCA.

Air temperature and humidity impact out-of-hospital-cardiac-arrests in Germany: A 10-year cohort study from the German Resuscitation Registry.

Objectives: This study examines the impact of temperature variations on out-of-hospital-cardiac-arrests in Germany over a decade (2010-2019). Out-of-hospital-cardiac-arrests affects 164 per 100,000 inhabitants annually in Germany, 11% survive to hospital discharge. The following study investigates days with the following characteristics: summer days, frost days, and high humidity days. Furthermore, the study explores incidence, causes, demographics, and outcomes of out-of-hospital-cardiac-arrests. Methods: Data from the German Resuscitation Registry and Meteorological Service were combined for analysis. The theory posits that temperature and humidity play a significant role in the occurrence and outcomes of out-of-hospital-cardiac-arrests, potentially triggering pre-existing health issues. Results: Findings reveal increased out-of-hospital-cardiac-arrests during frost days (6.39 up to 7.00, p < 0.001) monthly per 100,000 inhabitants), notably due to cardiac-related causes. Conversely, out-of-hospital-cardiac-arrests incidence decreases on summer days (6.61-5.79, p < 0.001 monthly per 100,000 inhabitants). High-humidity days exhibit a statistically significant increase in out-of-hospital-cardiac-arrests incidence (6.43-6.89, p < 0.001 monthly per 100,000 inhabitants). Conclusion: In conclusion, there's a notable rise in out-of-hospital-cardiac-arrests incidence and worse outcomes during cold days, and a significant increase in out-of-hospital-cardiac-arrests during high-humidity days. Moreover, extreme temperature events in unaccustomed regions also elevate out-of-hospital-cardiac-arrests rates. However, the dataset lacks sufficient hot days for conclusive findings, hinting that very hot days might also affect out-of-hospital-cardiac-arrests incidence. Further research, particularly on hotter days, is essential.No third-party funding was received for this study.

Cardiopulmonary resuscitation guidance improves medical students' adherence to guidelines in simulated cardiac arrest: a randomised cross-over study.

BACKGROUND: The 2010 Resuscitation Guidelines require high-quality chest compression and rapid defibrillation for patients with ventricular fibrillation with rhythm analysis and defibrillation repeated every 2 min. A lack of adherence to the guidelines by medical students was observed during simulated resuscitation training. OBJECTIVES: To assess whether real-time cardiopulmonary resuscitation guidance, including an audiovisual countdown timer, a metronome, a display of the chest compression quality and voice prompts, might improve adherence to the guidelines by medical students. DESIGN: Randomised cross-over simulation study. SETTING: Studienhospital Münster, Faculty of Medicine University Münster, Germany PARTICIPANTS: One hundred and forty-one medical students (fifth year) in 47 teams. INTERVENTION: Simulated resuscitation with and without real-time cardiopulmonary resuscitation guidance. MAIN OUTCOME MEASURES: The preshock pause, postshock pause, fraction of time without chest compression and defibrillation intervals. Observed quality parameters were chest compression depth and chest compression rate. RESULTS: With real-time cardiopulmonary resuscitation guidance, there were improved mean (SD) chest compression rates (105 ±â€Š8 vs. 121 ±â€Š12 bpm; P < 0.005), fewer inappropriate shock intervals [median (interquartile range) 0 (1 to 5) vs. 4 (1 to 7); P < 0.005], a smaller fraction of time without chest compression (18.9 ±â€Š4.4 vs. 22.5 ±â€Š7.0%; P < 0.005) and shorter postshock pauses (2.3 ±â€Š0.9 vs. 3.4 ±â€Š1.2 s; P < 0.005). CONCLUSION: Real-time cardiopulmonary resuscitation guidance significantly increased adherence to the guidelines by medical students treating simulated out-of-hospital cardiac arrest. Using a simple tool such as a countdown timer makes it possible to reduce the number of inappropriate shock intervals and time without chest compression.

[Teaching resuscitation in schools: "The earlier, the better...."]. / Laienreanimation--Reanimation als Schulfach: "Was Hänschen nicht lernt "

Sudden cardiac arrest is a major contributor to avoidable deaths in Europe. Immediate start of basic life support (BLS) by laypersons is among the most successful strategies in the treatment of cardiac arrest patients. Despite the fact that more than half of all cardiac arrests in Germany are witnessed by a bystander, only in one fifth of all arrests layperson resuscitation is initiated. One strategy to enhance bystander BLS is to establish cardiac resuscitation tuition in schools. BLS instructions for pupils have been proven to be successfully implemented independent from children's age or physical ability. Although an age-adjusted curriculum seems reasonable even usage of automatic external defibrillators (AED) can be taught effectually. The earlier in the life of a student BLS-instruction begins, the more successful the training is. However a national German curriculum for BLS-training in schools has yet to be established in Germany.

[In-hospital emergency care of patients with in-hospital cardiac arrest]. / Notfälle im Krankenhaus. Innerklinische Notfallversorgung bei Patienten mit einem Herz-Kreislauf-Stillstand.

In German hospitals there is a growing need to offer a high quality in-hospital emergency care, because of the increasing age of the patients and to the shortening of hospital stay, as well as the increasingly complex medical procedures increases the risk of emergencies. The in-hospital emergency care should not be different from the pre-hospital emergency care concerning both the training of personnel, as well as the equipment of the team. The incidence of in-hospital emergencies or sudden cardiac arrest is not known for Germany, but the frequency in the hospitals of different levels of care differs. To ensure high quality in-hospital resuscitation and emergency treatment training and equipment of the emergency teams should be optimized and a comprehensive documentation and analysis tool should be established. For the latter task the German Resuscitation Registry will offer a high sophisticated in-hospital-emergency data collecting and analysis tool.

[Bystander resuscitation: the impact of first aid on survival]. / Laienreanimation--Einfluss von Erster Hilfe auf das Überleben.

About 75000 people suffer from sudden cardiac arrest in Germany every year. 47% of all out-of-hospital cardiac arrests (OHCA) in Germany are bystander witnessed, but in only 16.1% is bystander-initiated CPR undertaken. In comparison to other countries, Germany is in the last third of bystander-initiated CPR activities. But bystander CPR is one of the most important measures contributing to a good neurological outcome after OHCA. New methods and concepts have to be developed to bring the knowledge of CPR to the general public in Germany and to improve the international standing.

Accelerometry-Based Classification of Circulatory States During Out-of-Hospital Cardiac Arrest.

OBJECTIVE: Exploit accelerometry data for an automatic, reliable, and prompt detection of spontaneous circulation during cardiac arrest, as this is both vital for patient survival and practically challenging. METHODS: We developed a machine learning algorithm to automatically predict the circulatory state during cardiopulmonary resuscitation from 4-second-long snippets of accelerometry and electrocardiogram (ECG) data from pauses of chest compressions of real-world defibrillator records. The algorithm was trained based on 422 cases from the German Resuscitation Registry, for which ground truth labels were created by a manual annotation of physicians. It uses a kernelized Support Vector Machine classifier based on 49 features, which partially reflect the correlation between accelerometry and electrocardiogram data. RESULTS: Evaluating 50 different test-training data splits, the proposed algorithm exhibits a balanced accuracy of 81.2%, a sensitivity of 80.6%, and a specificity of 81.8%, whereas using only ECG leads to a balanced accuracy of 76.5%, a sensitivity of 80.2%, and a specificity of 72.8%. CONCLUSION: The first method employing accelerometry for pulse/no-pulse decision yields a significant increase in performance compared to single ECG-signal usage. SIGNIFICANCE: This shows that accelerometry provides relevant information for pulse/no-pulse decisions. In application, such an algorithm may be used to simplify retrospective annotation for quality management and, moreover, to support clinicians to assess circulatory state during cardiac arrest treatment.

The aerobic respiratory chain of Escherichia coli: from genes to supercomplexes.

In spite of the large number of reports on the aerobic respiratory chain of Escherichia coli, from gene transcription regulation to enzyme kinetics and structural studies, an integrative perspective of this pathway is yet to be produced. Here, a multi-level analysis of the aerobic respiratory chain of E. coli was performed to find correlations between gene transcription, enzyme activity, growth dynamics, and supercomplex formation and composition. The transcription level of all genes encoding the aerobic respiratory chain of E. coli varied significantly in response to bacterial growth. Coordinated expression patterns were observed between the genes encoding NADH : quinone oxidoreductase and complex I (NDH-1), alternative NADH : quinone oxidoreductase (NDH-2) and cytochrome bdI, and also between sdhA and appC, encoding succinate dehydrogenase and cytochrome bdII, respectively. In general, the rates of the respiratory chain activities increased from mid-exponential to late-stationary phase, with no significant further variation occurring until the mid-stationary phase. Multi-level correlations between gene transcription, enzyme activity and growth dynamics were also found in this study. The previously reported NADH dehydrogenase and formate : oxygen oxidoreductase supercomplexes of E. coli were already assembled at mid-exponential phase and remained throughout growth. A new succinate oxidase supercomplex composed of succinate dehydrogenase and cytochrome bdII was identified, in agreement with the suggestion provided by the coordinated transcription of sdhA and appC.

[Prehospital treatment of polytrauma patients by emergency physicians]. / Erste Hilfe und Traumamanagement - Leitliniengerechtes Vorgehen in der Prähospitalphase.

Even in the 21st century major trauma still contributes to a svere loss of life in our society. Severly injured victims benefit from prehospital care that both considers tactical and medical aims. Knowledge of major trauma care has grown over the past years. The 2011 german guidelines on multiple- and severe trauma care set a milestone for better treatment of these patients. Trauma courses do not only teach theoretical knowledge but do also train participants in skills. By putting up the new structure of german traumacenters involving certified trauma hospitals it is easier for ambulance doctors to find the best hospital for their patient. Thought has been given to nearly al organ systems and body-areas in the guidelines making them a very usefull orientation guide for prehospital care. Emergency anesthesie including intubation is a mayor issue of the new guidelines.

A sliding-window based algorithm to determine the presence of chest compressions from acceleration data.

This publication presents in detail five exemplary cases and the algorithm used in the article (Orlob et al. 2022). Defibrillator records for the five exemplary cases were obtained from the German Resuscitation Registry. They consist of accelerometry, electrocardiogram and capnography time series as well as defibrillation times, energies and impedance when recorded. For these cases, experienced physicians annotated time points of cardiac arrest and return of spontaneous circulation or termination of resuscitation attempts, as well as the beginning and ending of every single chest compression period in consensus, as described in Orlob et al. (2022). Furthermore, an algorithm was developed which reliably detects chest compression periods automatically without the time-consuming process of manual annotation. This algorithm allows for an usage in automatic resuscitation quality assessment, machine learning approaches, and handling of big amounts of data (Orlob et al. 2022).

Impact of COVID-19 on out-of-hospital cardiac arrest: A registry-based cohort-study from the German Resuscitation Registry.

INTRODUCTION: The global COVID-19 pandemic effects people and the health system. Some international studies reported an increasing number of out-of-hospital cardiac arrest (OHCA). Comparable studies regarding the impact of COVID-19 on incidence and outcome of OHCA are not yet available for Germany. MATERIALS AND METHODS: This epidemiological study from the German Resuscitation Registry (GRR) compared a non-pandemic period (01.03.2018-28.02.2019) and a pandemic period (01.03.2020-28.02.2021) regarding the pandemic-related impact on OHCA care. RESULTS: A total of 18,799 cases were included. The incidence of OHCA (non-pandemic 117.9 vs. pandemic period 128.0/100,000 inhabitants) and of OHCA with resuscitation attempted increased (66.0 vs. 69.1/100,000). OHCA occurred predominantly and more often at home (62.8% vs. 66.5%, p<0.001). The first ECG rhythm was less often shockable (22.2% vs. 20.3%, p = 0.03). Fewer cases of OHCA were observed (58.6% vs. 55.6% p = 0.02). Both the bystander resuscitation rate and the proportion of telephone guided CPR remained stable (38.6% vs. 39.8%, p = 0.23; and 22.3% vs. 22.5%, p = 0.77). EMS arrival times increased (08:39 min vs. 09:08 min, p<0.001). Fewer patients reached a return of spontaneous circulation (ROSC) (45.4% vs. 40.9%, p<0.001), were admitted to hospital (50.2% vs. 45.0%, p<0.001), and discharged alive (13.9% vs. 10.2%, p<0.001). DISCUSSION: Survival after OHCA significantly decreased while the bystander resuscitation rate remained stable. However, longer EMS arrival times and fewer cases of witnessed OHCA may have contributed to poorer survival. Any change to EMS systems in the care of OHCA should be critically evaluated as it may mean a real loss of life-regardless of the pandemic situation.

Chest compression fraction calculation: A new, automated, robust method to identify periods of chest compressions from defibrillator data - Tested in Zoll X Series.

AIM: To introduce and evaluate a new, open-source algorithm to detect chest compression periods automatically by the rhythmic, high amplitude signals from an accelerometer, without processing single chest compression events, and to consecutively calculate the chest compression fraction (CCF). METHODS: A consecutive sample of defibrillator records from the German Resuscitation Registry was obtained and manually annotated in consensus as ground truth. Chest compression periods were determined by different automatic approaches, including the new algorithm. The diagnostic performance of these approaches was assessed. Further, using the different approaches in conjunction with different granularities of manual annotation, several CCF versions were calculated and compared by intraclass correlation coefficient (ICC). RESULTS: 131 defibrillator recordings with a total duration of 5755 minutes were analysed. The new algorithm had a sensitivity of 99.39 (95% CI 99.38, 99.41)% and specificity of 99.17 (95% CI 99.15; 99.18)% to detect chest compressions at any given timepoint. The ICC compared to ground truth was 0.998 for the new algorithm and 0.999 for manual annotation, while the ICC of the proposed algorithm compared to the proprietary software was 0.978. The time required for manual annotation to calculate CCF was reduced by 70.48 (22.55, [94.35, 14.45])%. CONCLUSION: The proposed algorithm reliably detects chest compressions in defibrillator recordings. It can markedly reduce the workload for manual annotation, which may facilitate uniform reporting of measured quality of cardiopulmonary resuscitation. The algorithm is made freely available and may be used in big data analysis and machine learning approaches.