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Nellie The Elephant And CPR Or, What About Babar?
Listening to music during CPR training could improve technique
(Research: Effect of listening to Nellie the Elephant during CPR
training on performance of chest compressions by lay people:
randomised crossover trial)
Listening to music during cardiopulmonary resuscitation (CPR)
training may help people keep to the recommended compression rate,
according to a study in the Christmas issue published on bmj.com
Cardiopulmonary resuscitation is an important lifesaving technique
that can be effectively taught to most people. When initiated by a
bystander one to two minutes before emergency services arrive it
can double survival rates.
Mentally singing the nursery tune Nellie the Elephant is sometimes
recommended during CPR training because of its appropriate rhythm and
tempo to help individuals keep a rate of 100 compressions per minute,
as recommended by UK Resuscitation
So a team of researchers from the Universities of Birmingham,
Coventry and Hertfordshire, and the West Midlands Ambulance Service
NHS Trust, set out to test whether this really does help lay people
to improve their CPR performance.
A total of 130 staff and students at Coventry University,
untrained in CPR, were given a brief demonstration on a resuscitation
manikin and had one minute to practise while listening to a metronome.
Participants were then asked to perform three sequences of one
minute of continuous chest compressions accompanied by no music,
repeated choruses of Nellie the Elephant by Little Bear, and That's
the Way (I Like It) by KC and the Sunshine Band via headphones.
Both songs were chosen for their appropriate tempo - 105 beats per
minute (bpm) for Nellie the Elephant and 109 bpm for That's the Way
(I Like It).
Listening to Nellie the Elephant significantly increased the
proportion of participants delivering compression rates at close
to 100 per minute (32%) compared with 12% for no music and 9% for
That's the Way (I Like It).
Unfortunately, it also increased the proportion of compressions
delivered at an inadequate depth.
As current resuscitation guidelines give equal emphasis to correct
compression rate and depth, listening to Nellie the Elephant as a
learning aid during CPR training cannot be recommended, say the
An earlier pilot study used the Bee Gees song Stayin' Alive.
The BMJ authors suggest that further research is required to
identify music that, when played during CPR training, improves chest
compression performance. Potential tunes include Another One Bites
the Dust by Queen, Quit Playing Games (With my Heart) by the
Backstreet Boys, and Achy Breaky Heart by Billy Ray Cyrus.
Malcolm Woollard, Professor in Pre-hospital and Emergency Care,
Pre-hospital, Emergency and Cardiovascular Care Applied Research
Group, Coventry University,
Email: [email protected]