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Dainty K, Debaty G, Waddick J, Vaillancourt C, Malta Hansen C, Olasveengen T, Bray J. Interventions to optimize dispatcher-assisted CPR instructions: A scoping review. Resusc Plus 2024; 19:100715. [PMID: 39135732 PMCID: PMC11318549 DOI: 10.1016/j.resplu.2024.100715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 08/15/2024] Open
Abstract
Aim To review and summarize existing literature and knowledge gaps regarding interventions that have been tested to optimize dispatcher-assisted CPR (DA-CPR) instruction protocols for out-of-hospital cardiac arrest (OHCA). Methods This scoping review was undertaken by an International Liaison Committee on Resuscitation (ILCOR) Basic Life Support scoping review team and guided by the ILCOR methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Studies were eligible for inclusion if they were published in peer-reviewed journals and evaluated interventions used to improve DA-CPR. The search was carried out in MEDLINE, EMBASE, Education Resources Information Center (ERIC), PsycINFO, the Cochrane Library, Evidence Based Medicine (EBM) Reviews, and the Campbell Library from 2000 to December 18, 2023. Results After full text review, 31 studies were included in the final review. The interventions reviewed were use of video at the scene (n = 9), changes in terminology about compressions (n = 6), implementation of novel DA-CPR protocols (n = 4), advanced dispatcher training (n = 3), centralization of the dispatch center (n = 2), use of metronome or varied metronome rates (n = 2), change in CPR sequence and compression ratio (n = 1), animated audio-visual recording (n = 1), pre-recorded instructions vs. conversational live instructions (n = 1), inclusion of "undress patient" instructions (n = 1), and specific verbal encouragement (n = 1). Studies ranged in methodology from registry studies to randomized clinical trials with the majority being observational studies of simulated EMS calls for OHCA. Outcomes were highly variable but included rates of bystander CPR, confidence & willingness to perform CPR, time to initiation of bystander CPR, bystander CPR quality (including CPR metrics: chest compression depth and rate; chest compression fraction; full chest recoil, ventilation rate, overall CPR competency), rates of automated external defibrillator (AED) use, return of spontaneous circulation (ROSC) and survival. Overall, all interventions seem to be associated with potential improvement in bystander CPR and CPR metrics. Conclusion There appears to be trends towards improvement on key outcomes however more research is needed. This scoping review highlights the lack of high-quality clinical research on any of the tested interventions to improve DA-CPR. There is insufficient evidence to explore the effectiveness of any of these interventions via systematic review.
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Affiliation(s)
- K.N. Dainty
- North York General Hospital, Toronto Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto Canada
| | - G. Debaty
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France
- University of Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - J. Waddick
- North York General Hospital, Toronto Canada
| | - C. Vaillancourt
- Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada
| | - C. Malta Hansen
- Copenhagen Emergency Medical Services, Copenhagen University, Denmark
- Department of Cardiology, Gentofte and Herlev Hospital, Copenhagen University, Denmark
- Department of Cardiology, Rigshospitalet, Copenhagen University, Denmark
- Department of Clinical Medicine, Copenhagen University, Denmark
| | - T. Olasveengen
- Institute of Clinical Medicine, University of Oslo and Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Norway
| | - J. Bray
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - International Liaison Committee on Resuscitation Basic Life Support Task Force
- North York General Hospital, Toronto Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto Canada
- Emergency Department and Mobile Intensive Care Unit, University Hospital of Grenoble Alpes, Grenoble, France
- University of Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
- Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Canada
- Copenhagen Emergency Medical Services, Copenhagen University, Denmark
- Department of Cardiology, Gentofte and Herlev Hospital, Copenhagen University, Denmark
- Department of Cardiology, Rigshospitalet, Copenhagen University, Denmark
- Department of Clinical Medicine, Copenhagen University, Denmark
- Institute of Clinical Medicine, University of Oslo and Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Norway
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Ohk T, Cho J, Yang G, Ahn M, Lee S, Kim W, Lee T. Effectiveness of a dispatcher-assisted CPR using an animated image: Simulation study. Am J Emerg Med 2024; 78:132-139. [PMID: 38271790 DOI: 10.1016/j.ajem.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Considering the few studies evaluating bystander cardiopulmonary resuscitation (CPR) performance, we sought to analyze differences in bystander CPR performance with and without the use of our self-developed animated GIFs based on dispatcher-assisted CPR simulation. METHODS A total of 80 adults who had not received CPR training over the past two years participated in the study. Among them, 40 people were classified into the auditory group (receiving CPR instructions only over the phone), and the other 40 people were classified into the audiovisual group (receiving CPR instructions over the phone after receiving images on a smartphone). All participants were asked to perform adult and infant CPR for 2 min. CPR performance was recorded using two video cameras (front and side) and analyzed by two emergency physicians, whereas CPR quality was measured using Resusci Anne & Baby QCPR Mk II (Laerdal). RESULTS In the adult CPR study, the audiovisual group had higher performance scores for adequacy of "knee position," "hand posture," "elbow extension," and "vertical compression," as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). No significant difference in CPR quality was observed between the two groups. In the infant CPR study, audiovisual group had higher performance scores in adequacy of "compression site," "finger posture," and "vertical compression," as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). Regarding CPR quality, the audiovisual group had higher scores for "adequate compression rate ratio" (p = 0.047). CONCLUSION Audiovisual guidance using animated GIFs more effectively improved CPR Standard Posture Completeness and Instruction Performance than did traditional auditory guidance.
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Affiliation(s)
- TaekGeun Ohk
- Department of Emergency Medicine, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea; Department of Emergency Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - JunHwi Cho
- Department of Emergency Medicine, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea; Department of Emergency Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Goeun Yang
- Department of Radiology, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea; Department of Radiology, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Mooeob Ahn
- Department of Emergency Medicine, Chuncheon Sacred Heart hospital, Hallym College of Medicine, Chuncheon, Republic of Korea
| | - SangJong Lee
- Gangwon Fire Headquarters, Chuncheon, Republic of Korea
| | - WanSoo Kim
- Gangwon Fire Headquarters, Chuncheon, Republic of Korea
| | - TaeHun Lee
- Department of Emergency Medicine, Chuncheon Sacred Heart hospital, Hallym College of Medicine, Chuncheon, Republic of Korea.
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Bielski K, Böttiger BW, Pruc M, Gasecka A, Sieminski M, Jaguszewski MJ, Smereka J, Gilis-Malinowska N, Peacock FW, Szarpak L. Outcomes of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation: a systematic review and meta-analysis. Ann Med 2022; 54:464-471. [PMID: 35107406 PMCID: PMC8812740 DOI: 10.1080/07853890.2022.2032314] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). METHODS We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. RESULTS Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR = 0.46; 95% CI: 0.30, 0.69; I2 = 66%; p < .001), 10.7% vs. 22.3% of survival to hospital discharge (OR = 0.46; 95% CI: 0.30, 0.70; I2 = 69%; p < .001), and 6.3% vs. 16.0% of survival to hospital discharge with a good neurological outcome (OR = 0.39; 95% CI: 0.23, 0.67; I2 = 73%; p < .001). In simulation trials, chest compression rate per minute equalled 91.3 ± 22.6 for C-DACPR and 107.8 ± 12.6 for V-DACPR (MD = -13.40; 95% CI: -21.86, -4.95; I2 = 97%; p = .002). The respective values for chest compression depth were 38.7 ± 14.3 and 41.8 ± 12.5 mm (MD = -2.67; 95% CI: -8.35, 3.01; I2 = 98%; p = .36). CONCLUSIONS As compared with C-DACPR, V-DACPR significantly increased prehospital ROSC and survival to hospital discharge. Under simulated resuscitation conditions, V-DACPR exhibited a higher rate of adequate chest compressions than C-DACPR.Key messagesBystander cardiopulmonary resuscitation parameters significantly depend on the dispatcher's support and the manner of the support provided.Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation can increase the rate of prehospital return of spontaneous circulation and survival to hospital discharge.Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation improves the quality of chest compressions compared with dispatcher-assisted resuscitation without video instruction.
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Affiliation(s)
- Karol Bielski
- Institute of Outcomes Research, Polonia University, Czestochowa, Poland.,Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland
| | - Bernd W Böttiger
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Michal Pruc
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland
| | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands.,First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | | | - Jacek Smereka
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland.,Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | | | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States
| | - Lukasz Szarpak
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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Pan DF, Li ZJ, Ji XZ, Yang LT, Liang PF. Video-assisted bystander cardiopulmonary resuscitation improves the quality of chest compressions during simulated cardiac arrests: A systemic review and meta-analysis. World J Clin Cases 2022; 10:11442-11453. [PMID: 36387811 PMCID: PMC9649565 DOI: 10.12998/wjcc.v10.i31.11442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/10/2022] [Accepted: 09/27/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It remains unclear whether video aids can improve the quality of bystander cardiopulmonary resuscitation (CPR).
AIM To summarize simulation-based studies aiming at improving bystander CPR associated with the quality of chest compression and time-related quality parameters.
METHODS The systematic review was conducted according to the PRISMA guidelines. All relevant studies were searched through PubMed, EMBASE, Medline and Cochrane Library databases. The risk of bias was evaluated using the Cochrane collaboration tool.
RESULTS A total of 259 studies were eligible for inclusion, and 6 randomised controlled trial studies were ultimately included. The results of meta-analysis indicated that video-assisted CPR (V-CPR) was significantly associated with the improved mean chest compression rate [OR = 0.66 (0.49-0.82), P < 0.001], and the proportion of chest compression with correct hand positioning [OR = 1.63 (0.71-2.55), P < 0.001]. However, the difference in mean chest compression depth was not statistically significant [OR = 0.18 (-0.07-0.42), P = 0.15], and V-CPR was not associated with the time to first chest compression compared to telecommunicator CPR [OR = -0.12 (-0.88-0.63), P = 0.75].
CONCLUSION Video real-time guidance by the dispatcher can improve the quality of bystander CPR to a certain extent. However, the quality is still not ideal, and there is a lack of guidance caused by poor video signal or inadequate interaction.
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Affiliation(s)
- Dong-Feng Pan
- Department of Emergency Medicine, The First Affiliated Hospital of Northwest Minzu University, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
- Department of Emergency Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
| | - Zheng-Jun Li
- Department of Emergency Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
| | - Xin-Zhong Ji
- Department of Emergency Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
| | - Li-Ting Yang
- Department of Emergency Medicine, The Third Clinical Medical College of Ningxia Medical University, Yinchuan 750002, Ningxia Hui Autonomous Region, China
| | - Pei-Feng Liang
- Department of Medicine Statistics, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, Ningxia Hui Autonomous Region, China
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, El-Naggar W, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami MD, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation 2021; 145:e645-e721. [PMID: 34813356 DOI: 10.1161/cir.0000000000001017] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, Zideman D, Bhanji F, Andersen LW, Avis SR, Aziz K, Bendall JC, Berry DC, Borra V, Böttiger BW, Bradley R, Bray JE, Breckwoldt J, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Davis PG, de Almeida MF, de Caen AR, de Paiva EF, Deakin CD, Djärv T, Douma MJ, Drennan IR, Duff JP, Eastwood KJ, Epstein JL, Escalante R, Fabres JG, Fawke J, Finn JC, Foglia EE, Folke F, Freeman K, Gilfoyle E, Goolsby CA, Grove A, Guinsburg R, Hatanaka T, Hazinski MF, Heriot GS, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hung KKC, Hsu CH, Ikeyama T, Isayama T, Kapadia VS, Kawakami M, Kim HS, Kloeck DA, Kudenchuk PJ, Lagina AT, Lauridsen KG, Lavonas EJ, Lockey AS, Malta Hansen C, Markenson D, Matsuyama T, McKinlay CJD, Mehrabian A, Merchant RM, Meyran D, Morley PT, Morrison LJ, Nation KJ, Nemeth M, Neumar RW, Nicholson T, Niermeyer S, Nikolaou N, Nishiyama C, O'Neil BJ, Orkin AM, Osemeke O, Parr MJ, Patocka C, Pellegrino JL, Perkins GD, Perlman JM, Rabi Y, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Sawyer T, Schmölzer GM, Schnaubelt S, Semeraro F, Skrifvars MB, Smith CM, Smyth MA, Soll RF, Sugiura T, Taylor-Phillips S, Trevisanuto D, Vaillancourt C, Wang TL, Weiner GM, Welsford M, Wigginton J, Wyllie JP, Yeung J, Nolan JP, Berg KM. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2021; 169:229-311. [PMID: 34933747 PMCID: PMC8581280 DOI: 10.1016/j.resuscitation.2021.10.040] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS). Prehosp Disaster Med 2021; 36:702-707. [PMID: 34645532 DOI: 10.1017/s1049023x21001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). METHODS This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. RESULTS There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. CONCLUSION Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.
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Metelmann C, Metelmann B, Schuffert L, Hahnenkamp K, Vollmer M, Brinkrolf P. Smartphone apps to support laypersons in bystander CPR are of ambivalent benefit: a controlled trial using medical simulation. Scand J Trauma Resusc Emerg Med 2021; 29:76. [PMID: 34082804 PMCID: PMC8173850 DOI: 10.1186/s13049-021-00893-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a beneficial addition to traditional resuscitation training? METHODS In this controlled trial, we assessed the impact of app use on the quality of resuscitation (hands-off time, assessment of the patient's condition, quality of chest compression, body and arm positioning). Pupils who have previously undergone a standardised resuscitation training, encountered a simulated cardiac arrest either (i) without an app (control group); (ii) with facultative app usage; or (iii) with mandatory app usage. Measurements were compared using generalised linear regression. RESULTS 200 pupils attended this study with 74 pupils in control group, 65 in facultative group and 61 in mandatory group. Participants who had to use the app significantly delayed the check for breathing, call for help, and first compression, leading to longer total hands-off time. Hands-off time during chest compression did not differ significantly. The percentage of correct compression rate and correct compression depth was significantly higher when app use was mandatory. Assessment of the patient's condition, and body and arm positioning did not differ. CONCLUSIONS Smartphone apps offering real-time guidance in resuscitation can improve the quality of chest compression but may also delay the start of resuscitation. Provided that the app gives easy-to-implement, guideline-compliant instructions and that the user is familiar with its operation, we recommend smartphone-guidance as an additional tool to hands-on CPR-training to increase the prevalence and quality of bystander-initiated CPR.
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Affiliation(s)
- Camilla Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Bibiana Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Louisa Schuffert
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Klaus Hahnenkamp
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Peter Brinkrolf
- Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany
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Lee SGW, Kim TH, Lee HS, Shin SD, Song KJ, Hong KJ, Kim JH, Park YJ. Efficacy of a new dispatcher-assisted cardiopulmonary resuscitation protocol with audio call-to-video call transition. Am J Emerg Med 2021; 44:26-32. [PMID: 33578328 DOI: 10.1016/j.ajem.2021.01.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/18/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Video call based dispatcher-assisted cardiopulmonary resuscitation (V-DACPR) has been suggested to improve the quality of bystander cardiopulmonary resuscitation. In the current system, dispatchers must convert the audio calls to video calls to provide V-DACPR. We aimed to develop new audio call-to-video call transition protocols and test its efficacy and safety compared to conventional DACPR(C-DACPR). METHODS This was a randomized controlled simulation trial that compared the quality of bystander chest compression that was performed under three different DACPR protocols: C-DACPR, V-DACPR with rapid transition, and V-DACPR with delayed transition. Adult volunteers excluding healthcare providers were recruited for the trial. The primary outcome of the study was the mean proportion of adequate hand positioning during chest compression. RESULTS Simulation results of 131 volunteers were analyzed. The mean proportion of adequate hand positioning was highest in V-DACPR with rapid transition (V-DACPR with rapid transition vs. C-DACPR: 92.7% vs. 82.4%, p = 0.03). The mean chest compression depth was deeper in both V-DACPR groups than in the C-DACPR group (V-DACPR with rapid transition vs. C-DACPR: 40.7 mm vs. 35.9 mm, p = 0.01, V-DACPR with delayed transition vs. C- DACPR: 40.9 mm vs. 35.9 mm, p = 0.01). Improvement in the proportion of adequate hand positioning was observed in the V-DACPR groups (r = 0.25, p < 0.01 for rapid transition and r = 0.19, p < 0.01 for delayed transition). CONCLUSION Participants in the V-DACPR groups performed higher quality chest compression with higher appropriate hand positioning and deeper compression depth compared to the C-DACPR group.
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Affiliation(s)
- Stephen Gyung Won Lee
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Tae Han Kim
- Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Hee Soon Lee
- EMS Situation Management Center, Seoul Emergency Operation Center, Seoul Metropolitan Fire & Disaster Headquarters, Republic of Korea.
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Jong Hwan Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute.
| | - Yong Joo Park
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute; National EMS Control Center, National Fire Agency, Sejong, Korea.
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Dong X, Zhang L, Myklebust H, Birkenes TS, Zheng ZJ. Effect of a real-time feedback smartphone application (TCPRLink) on the quality of telephone-assisted CPR performed by trained laypeople in China: a manikin-based randomised controlled study. BMJ Open 2020; 10:e038813. [PMID: 33023877 PMCID: PMC7539615 DOI: 10.1136/bmjopen-2020-038813] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To determine the effect of a free smartphone application (TCPRLink) that provides real-time monitoring and audiovisual feedback on chest compressions (CC) on trained layperson telephone-assisted cardiopulmonary resuscitation (T-CPR) performance. DESIGN A manikin-based randomised controlled study. SETTING This study was conducted at a multidisciplinary university and a community centre in China. PARTICIPANTS One hundred and eighty-six adult participants (age 18-65 years) with T-CPR training experience were randomly assigned to the TCPRLink (n=94) and T-CPR (n=92) groups with age stratification. INTERVENTIONS We compared the participants' performance for 6 min of CC in a simulated T-CPR scenario both at the baseline and after 3 months. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were the CC rate and proportion of adequate CC rate (100-120 min-1). The secondary outcomes included the proportion of participants counting the CC rhythm, time to first CC, CC depth, hands-off time and CC full-release ratio. RESULTS Participants in the TCPRLink feedback group more consistently performed CC with higher rate, both initially and 3 months later (median 111 (IQR 109-113) vs 108 (103-112) min-1, p=0.002 and 111 (109-113) vs 108 (105-112) min-1, p<0.001, respectively), with less need to count the rhythm (21.3% vs 41.3%, p=0.003% and 7% vs 22.6%, p=0.004, respectively) compared with the T-CPR group. There were no significant differences in time to the first CC, hands-off time or CC full-release ratio. Among 55-65 year group, the CC depth was deeper in the TCPRLink group than in the TCPR group (47.1±9.6 vs 38.5±8.7 mm, p=0.001 and 44.7±10.1 vs 39.3±10.8 mm, p=0.07, respectively). CONCLUSIONS The TCPRLink application improved T-CPR quality in trained laypersons to provide more effective CCs and lighten the load of counting out the CC with the dispatcher in a simulated T-CPR scenario. Further investigations are required to confirm this effectiveness in real-life resuscitation attempts.
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Affiliation(s)
- Xuejie Dong
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | | | | | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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A multidisciplinary approach for improving the outcome of out-of-hospital cardiac arrest in South Korea. Eur J Emerg Med 2019; 27:46-53. [PMID: 31166220 PMCID: PMC6946101 DOI: 10.1097/mej.0000000000000612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Direct medical control using video conferencing capabilities of smartphones has never been conducted in out-of-hospital cardiac arrest patients. This study was conducted to investigate the feasibility and treatment effectiveness of real-time smartphone video conferencing calls for the management of out-of-hospital cardiac arrest. METHODS This study was a pre-post-intervention prospective cohort study conducted from January 2013 to July 2015. The intervention was pre-hospital advanced life support under a physician's direction using a smartphone video call. RESULTS In total, 942 cardiac arrests occurred over the 2-year period; 308 patients were excluded, and 314 (49.5%) and 320 (50.5%) cardiac arrest patients were enrolled during the pre- and post-intervention study periods, respectively. There were 248/320 (77.5%) cases of smartphone video-assisted advanced life support during the post-intervention period. For patients in the pre- and post-intervention groups, the pre-hospital return of spontaneous circulation was 6.7 and 20%, respectively (adjusted odds ratio 3.3, 95% confidence interval 1.6-6.8, P < 0.01), and favourable neurological outcomes were ascertained in 1.9 and 6.9%, respectively (adjusted odds ratio 23.6, 95% confidence interval 3.4-164.0, P < 0.01). The smartphone voice and video quality were rated 8.5 and 8.2 out of 10, respectively, in physician evaluation, while the overall utility was rated 9.1. CONCLUSION We concluded that a multidisciplinary approach including the re-education of basic life support, simulation training for advanced life support, real-time medical direction via video call, and dispatching two teams rather than one team improved the outcome of out-of-hospital cardiac arrest.
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Chen KY, Ko YC, Hsieh MJ, Chiang WC, Ma MHM. Interventions to improve the quality of bystander cardiopulmonary resuscitation: A systematic review. PLoS One 2019; 14:e0211792. [PMID: 30759140 PMCID: PMC6373936 DOI: 10.1371/journal.pone.0211792] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/21/2019] [Indexed: 12/28/2022] Open
Abstract
Background Performing high-quality bystander cardiopulmonary resuscitation (CPR) improves the clinical outcomes of victims with sudden cardiac arrest. Thus far, no systematic review has been performed to identify interventions associated with improved bystander CPR quality. Methods We searched Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, Ovid PsycInfo, Thomson Reuters SCI-EXPANDED, and the Cochrane Central Register of Controlled Trials to retrieve studies published from 1 January 1966 to 5 October 2018 associated with interventions that could improve the quality of bystander CPR. Data regarding participant characteristics, interventions, and design and outcomes of included studies were extracted. Results Of the initially identified 2,703 studies, 42 were included. Of these, 32 were randomized controlled trials. Participants included adults, high school students, and university students with non-medical professional majors. Interventions improving bystander CPR quality included telephone dispatcher-assisted CPR (DA-CPR) with simplified or more concrete instructions, compression-only CPR, and other on-scene interventions, such as four-hand CPR for elderly rescuers, kneel on opposite sides for two-person CPR, and CPR with heels for a tired rescuer. Devices providing real-time feedback and mobile devices containing CPR applications or software were also found to be beneficial in improving the quality of bystander CPR. However, using mobile devices for improving CPR quality or for assisting DA-CPR might cause rescuers to delay starting CPR. Conclusions To further improve the clinical outcomes of victims with cardiac arrest, these effective interventions may be included in the guidelines for bystander CPR.
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Affiliation(s)
- Kuan-Yu Chen
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ying-Chih Ko
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: , (MHM); (MH)
| | - Wen-Chu Chiang
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan
| | - Matthew Huei-Ming Ma
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan
- * E-mail: , (MHM); (MH)
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CPR Guidance by an Emergency Physician via Video Call: A Simulation Study. Emerg Med Int 2018; 2018:1480726. [PMID: 30627442 PMCID: PMC6304577 DOI: 10.1155/2018/1480726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/20/2018] [Accepted: 11/12/2018] [Indexed: 11/18/2022] Open
Abstract
Background In South Korea, the prehospital treatment of cardiac arrest is generally led by an emergency medical technician-paramedic (EMT-P), and defibrillation is delivered by the automatic external defibrillator (AED). This study aimed at examining the effects of direct medical guidance by an emergency physician through a video call that enabled prompt manual defibrillation. Methods Two-hundred eighty-eight paramedics based in Gyeonggi Province were studied for four months, from July to November 2015. The participants were divided into 96 teams, and the teams were randomly divided into either a conventional group that was to use the AED or a video call guidance group which was to use the manual defibrillators, with 48 teams in each group. The time to first defibrillation, total hands-off time, and hands-off ratio were compared between the two groups. Results The median value of the time to the first defibrillation was significantly shorter in the video call guidance group (56 s) than in the conventional group (73 s) (p<0.001). The median value of the total hands-off time was also significantly shorter (228 vs. 285.5 s) (p<0.001), and the hands-off ratio, defined as the proportion of hands-off time out of the total CPR time, was significantly shorter in the video call guidance group (0.32 vs. 0.41) (p<0.001). Conclusion Physician-guided CPR with a video call enabled prompt manual defibrillation and significantly shortened the time required for first defibrillation, hands-off time, and hands-off ratio in simulated cases of prehospital cardiac arrest.
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Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MHM. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation 2018; 123:77-85. [DOI: 10.1016/j.resuscitation.2017.12.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/07/2017] [Accepted: 12/09/2017] [Indexed: 11/29/2022]
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Birkun A, Glotov M, Ndjamen HF, Alaiye E, Adeleke T, Samarin S. Pre-recorded instructional audio vs. dispatchers' conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study. World J Emerg Med 2018; 9:165-171. [PMID: 29796139 DOI: 10.5847/wjem.j.1920-8642.2018.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation. METHODS It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio (n=57); or (2) verbal dispatcher assistance (n=52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the first compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded. RESULTS There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P>0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the first compression (86.0±14.3 vs. 91.2±14.2 s, P<0.05), higher compression rate (94.9±26.4 vs. 89.1±32.8 min-1) and number of compressions provided (170.2±48.0 vs. 156.2±60.7). CONCLUSION When provided by untrained persons in the simulated settings, the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.
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Affiliation(s)
- Alexei Birkun
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Maksim Glotov
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Herman Franklin Ndjamen
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Esther Alaiye
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Temidara Adeleke
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
| | - Sergey Samarin
- Department of Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University; 295051, Lenin Blvd, 5/7, Simferopol, Russian Federation
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Park CS, Kang IG, Heo SJ, Chae YS, Kim HJ, Park SS, Lee MJ, Jeong WJ. A Randomised, Cross over Study Using a Mannequin Model to Evaluate the Effects on CPR Quality of Real-Time Audio-Visual Feedback Provided by a Smartphone Application. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791402100304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the effect of real time feedback provided by smartphone application on cardiopulmonary resuscitation (CPR) performance. Methods Participants were randomised in two groups based on whether chest compression with or without the assistance of the smartphone application. Both groups performed hands-only CPR on a mannequin for 4 minutes. Data on CPR performance of both groups was compared. To assess the reliability the feedback value, we compared the CPR data from Skillmeter and data from smartphone. A questionnaire survey to participants about the usefulness of the application was also evaluated. Results Twenty-one subjects were recruited for the study. We found no significant difference in mean chest compression rate (103.3±5.0/min vs. 107.1±1.7/min; p=0.133) and depth between the two groups (47.3 [39.3, 56.2] mm vs. 45.8 [40.3, 49.9] mm; p=0.085). The proportion of adequate compression depth over the total compression was significantly higher in the group using the smartphone (38.1% vs. 22.2%; p=0.034). The CPR data displayed on smartphone application in mannequin's chest was not different from Skillmeter software. The majority of the participants considered the application easy to use, but holding the smartphone during CPR hampered compression. Conclusions Real-time audio-visual feedback on CPR depth and rate using a smartphone application can help to maintain the adequate chest compression depth in prolonged CPR. A better method to hold the smartphone may maximise the feedback effect on CPR quality. (Hong Kong j.emerg.med. 2014;21:153-160)
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Affiliation(s)
- CS Park
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - IG Kang
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - SJ Heo
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - YS Chae
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - HJ Kim
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - SS Park
- Konyang University Hospital, Department of Emergency Medicine, Republic of Korea
| | - MJ Lee
- Kyungpook National University Hospital, Department of Emergency Medicine, Republic of Korea
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Real-time video telemedicine applications in the emergency department: a scoping review of literature. CAN J EMERG MED 2017; 20:920-928. [DOI: 10.1017/cem.2017.382] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AbstractObjectivesTo collect and synthesize the literature describing the use of real-time video-based technologies to provide support in the care of patients presenting to emergency departments.Data SourceSix electronic databases were searched, including Medline, CINAHL, Embase, the Cochrane Database, DARE, and PubMed for all publications since the earliest date available in each database to February 2016.Study SelectionSelected articles were full text articles addressing the use of telemedicine to support patient care in pre-hospital or emergency department settings. The search yielded 2976 articles for review with 11 studies eligible for inclusion after application of the inclusion and exclusion criteria. A scoping review of the selected articles was performed to better understand the different systems in place around the world and the current state of evidence supporting telemedicine use in the emergency department.ConclusionsTelemedicine support for emergency department physicians is an application with significant potential but is still lacking evidence supporting improved patient outcomes. Advances in technology, combined with more attractive price-points have resulted in widespread interest and implementation around the world. Applications of this technology that are currently being studied include support for minor treatment centres, patient transfer decision-making, management of acutely ill patients and scheduled teleconsultations.
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Rumsfeld JS, Brooks SC, Aufderheide TP, Leary M, Bradley SM, Nkonde-Price C, Schwamm LH, Jessup M, Ferrer JME, Merchant RM. Use of Mobile Devices, Social Media, and Crowdsourcing as Digital Strategies to Improve Emergency Cardiovascular Care. Circulation 2016; 134:e87-e108. [DOI: 10.1161/cir.0000000000000428] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Bystander cardiopulmonary resuscitation training experience and self-efficacy of age and gender group: a nationwide community survey. Am J Emerg Med 2016; 34:1331-7. [DOI: 10.1016/j.ajem.2015.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Indexed: 11/17/2022] Open
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Yuksen C, Sawatmongkornkul S, Tuangsirisup J, Sawanyawisuth K, Sittichanbuncha Y. The CPR outcomes of online medical video instruction versus on-scene medical instruction using simulated cardiac arrest stations. BMC Emerg Med 2016; 16:25. [PMID: 27405926 PMCID: PMC4942945 DOI: 10.1186/s12873-016-0092-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 06/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures. There are limited data on the effects of telemedicine in cardiac arrest situations in the literature particularly in Asian settings. METHODS This study was conducted by using two simulated cardiac arrest stations during the 2014 annual Thai national conference in emergency medicine. These two stations, nos. 5 and 11, were a part of the conference activity called "EMS rally" which was comprised of 14 stations. Both stations were shockable and out-of-hospital cardiac arrest situations; station 5 was online instructed, while station 11 was on-scene instructed. There were 14 representative teams from each province from all over Thailand who participated in the rally. Each team had one physician, one nurse, and two emergency medicine technicians. Eight CPR outcomes were evaluated and compared between the online versus on-scene situations. RESULTS There were 14 representative teams that participated in the study; a total of 14 physicians, 14 nurses, and 28 emergency medicine technicians. The average ages of participants in all three occupations were between the second and third decade of life. The percentages of participants with more than 3 years in ambulance experience was 7.1, 64.3, and 53.6 % in the physicians, nurses, and EMTs groups. The median times of all outcomes were significantly longer in the online group than the on-scene group including times from start to chest compression (total 102 vs 36 s), total times from the start to VT/VF detection (187 vs 99 s); times from VT/VF detection to the first defibrillation (57 vs 28 s); and times from the start of adrenaline injection (282 vs 165 s). The percentages of using amiodarone (21.43 % vs 57.14 %; p value < 0.001), establishment of a definitive airway (35.71 % vs 100 %; p value 0.003), and correct detections of pulseless electrical activity (PEA) (28.57 % vs 100 %; p value < 0.001) were significantly lower in the online group than the on-scene group. The high quality CPR outcomes between the online group and on-scene group were comparable. CONCLUSIONS The online medical instruction may have worse CPR outcomes compared with on-scene medical instruction in shockable, simulated CPR scenarios. Further studies are needed to confirm these results.
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Affiliation(s)
- Chaiyaporn Yuksen
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Sorravit Sawatmongkornkul
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Jarupol Tuangsirisup
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- The Research Center in Back, Neck Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Yuwares Sittichanbuncha
- Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
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Ikeda DJ, Buckler DG, Li J, Agarwal AK, Di Taranti LJ, Kurtz J, Reis RD, Leary M, Abella BS, Blewer AL. Dissemination of CPR video self-instruction materials to secondary trainees: Results from a hospital-based CPR education trial. Resuscitation 2016; 100:45-50. [PMID: 26776900 DOI: 10.1016/j.resuscitation.2015.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/30/2015] [Accepted: 12/19/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) video self-instruction (VSI) materials have been promoted as a scalable approach to increase the prevalence of CPR skills among the lay public, in part due to the opportunity for secondary training (i.e., sharing of training materials). However, the motivations for, and barriers to, disseminating VSI materials to secondary trainees is poorly understood. METHODS This work represents an ancillary investigation of a prospective hospital-based CPR education trial in which family members of cardiac patients were trained using VSI. Mixed-methods surveys were administered to primary trainees six months after initial enrollment. Surveys were designed to capture motivations for, and barriers to, sharing VSI materials, the number of secondary trainees with whom materials were shared, and the settings, timing, and recipients of trainings. RESULTS Between 07/2012 and 05/2015, 653 study participants completed a six-month follow-up interview. Of those, 345 reported sharing VSI materials with 1455 secondary trainees. Materials were shared most commonly with family members. In a logistic regression analysis, participants in the oldest quartile (age >63 years) were less likely to share materials compared to those in the youngest quartile (age ≤ 44 years, OR 0.58, CI 0.37-0.90, p=0.02). Among the 308 participants who did not share their materials, time constraints was the most commonly cited barrier for not sharing. CONCLUSIONS VSI materials represent a strategy for secondary dissemination of CPR training, yet older individuals have a lower likelihood of sharing relative to younger individuals. Further work is warranted to remedy perceived barriers to CPR dissemination among the lay public using VSI approaches.
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Affiliation(s)
- Daniel J Ikeda
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David G Buckler
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jiaqi Li
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amit K Agarwal
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura J Di Taranti
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James Kurtz
- Penn Presbyterian Medical Center, Philadelphia, PA, USA
| | - Ryan Dos Reis
- Penn Presbyterian Medical Center, Philadelphia, PA, USA
| | - Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin S Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Audrey L Blewer
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
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Kim HS, Kim H, Lee S, Lee KH, Kim JH. Current Clinical Status of Telehealth in Korea: Categories, Scientific Basis, and Obstacles. Healthc Inform Res 2015; 21:244-50. [PMID: 26618030 PMCID: PMC4659881 DOI: 10.4258/hir.2015.21.4.244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 09/17/2015] [Accepted: 09/18/2015] [Indexed: 11/28/2022] Open
Abstract
Objectives Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea. Methods We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea. Results Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence. Conclusions Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications.
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Affiliation(s)
- Hun-Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyunah Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - Suehyun Lee
- Seoul National University Biomedical Informatics (SNUBI) and Systems Biomedical Informatics Research Center, Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Kye Hwa Lee
- Seoul National University Biomedical Informatics (SNUBI) and Systems Biomedical Informatics Research Center, Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Han Kim
- Seoul National University Biomedical Informatics (SNUBI) and Systems Biomedical Informatics Research Center, Division of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
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Sakai T, Kitamura T, Nishiyama C, Murakami Y, Ando M, Kawamura T, Tasaki O, Kuwagata Y, Shimazu T, Iwami T. Cardiopulmonary resuscitation support application on a smartphone - randomized controlled trial. Circ J 2015; 79:1052-7. [PMID: 25740350 DOI: 10.1253/circj.cj-14-1258] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This simulation trial aimed to compare the quality of cardiopulmonary resuscitation (CPR) with and without the newly-developed CPR support application on smartphones. METHODS AND RESULTS In this trial, participants were randomly assigned to either the CPR support application group or the control group, stratified by sex and previous CPR training. Participants' CPR skills were evaluated by a 2-min case-based scenario test using the Leardal Resusci Anne PC Skill reporting Manikin System(®). The outcome measures were the proportion of chest compressions performed in each group and the number of total chest compressions and appropriate chest compressions performed during the 2-min test period. A total of 84 participants were enrolled and completed the protocol. All participants in the CPR support application group performed chest compressions, compared with only 31 (75.6%) in the control group (P<0.001). Among participants who performed chest compressions during the 2-min test period, the number of total chest compressions was significantly higher in the CPR support application group than in the control group (211.6±29.5 vs. 77.0±43.3, P<0.001). The number of appropriate chest compressions tended to be greater in the CPR support application group than in the control group, although it was statistically insignificant (30.3±57.3 vs. 17.2±28.7, P=0.246). CONCLUSIONS In this cohort of laypersons, the newly-developed CPR support application for smartphones contributed to increasing the implementation rate and the number of total chest compressions performed and may assist in improving the survival rate for out-of-hospital cardiac arrests (UMIN000004740).
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Affiliation(s)
- Tomohiko Sakai
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
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Honeyman E, Ding H, Varnfield M, Karunanithi M. Mobile health applications in cardiac care. Interv Cardiol 2014. [DOI: 10.2217/ica.14.4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bohm K, Castrén M. Emergency medical dispatch. With increasing research it is important to unify the reporting. Resuscitation 2014; 85:3-4. [DOI: 10.1016/j.resuscitation.2013.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
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Samuel S, Anne-Sophie D, Régine Z, Anne-Françoise D, Gary H, Vincent D, Alexandre G. Mobile phones video CPR: Preliminary results in a non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres. Resuscitation 2013. [DOI: 10.1016/j.resuscitation.2013.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Restart a Heart Day: A strategy by the European Resuscitation Council to raise cardiac arrest awareness. Resuscitation 2013; 84:1157-8. [DOI: 10.1016/j.resuscitation.2013.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 06/27/2013] [Indexed: 11/20/2022]
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Georgiou M, Lockey AS. ERC initiatives to reduce the burden of cardiac arrest: The European Cardiac Arrest Awareness Day. Best Pract Res Clin Anaesthesiol 2013; 27:307-15. [DOI: 10.1016/j.bpa.2013.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
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Thygerson SM, Rassbach AR, West JH, Thygerson AL. iPhone Apps for Cardiopulmonary Resuscitation (CPR): A Content Analysis. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2013. [DOI: 10.1080/15398285.2013.812912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Birkenes TS, Myklebust H, Kramer-Johansen J. Time delays and capability of elderly to activate speaker function for continuous telephone CPR. Scand J Trauma Resusc Emerg Med 2013; 21:40. [PMID: 23676015 PMCID: PMC3658871 DOI: 10.1186/1757-7241-21-40] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 05/04/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Telephone-CPR (T-CPR) can increase rate of bystander CPR as well as CPR quality. Instructions for T-CPR were developed when most callers used a land line. Telephones today are often wireless and can be brought to the patient. They often have speaker function which further allows the rescuer to receive instructions while performing CPR.We wanted to measure adult lay people's ability to activate the speaker function on their own mobile phone. METHODS Elderly lay people, previously trained in CPR, were contacted by telephone. Participants with speaker function experience were asked to activate this without further instructions, while participants with no experience were given instructions on how to activate it. Participants were divided in three groups; Group 1: Can activate the speaker function without instruction, Group 2: Can activate the speaker function with instruction, and Group 3: Unable to activate the speaker function. Time to activation for group 1 and 2 was compared using Mann-Whitney U-test. RESULTS Seventy-two elderly lay people, mean age 68 ± 6 years participated in the study. Thirty-five (35)% of the participants were able to activate the speaker function without instructions, 29% with instructions and 36% were unable to activate the speaker function. The median time to activate the speaker function was 8s and 93s, with and without instructions, respectively (p < 0.01). CONCLUSION One-third of the elderly could activate speaker function quickly, and two-third either used a long time or could not activate the function.
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Affiliation(s)
- Tonje S Birkenes
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, PO Box 4956 Nydalen, Oslo, N-0426, Norway
- Laerdal Medical AS, Tanke Svilandsgate 30, Stavanger, N-4002, Norway
| | - Helge Myklebust
- Laerdal Medical AS, Tanke Svilandsgate 30, Stavanger, N-4002, Norway
| | - Jo Kramer-Johansen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, PO Box 4956 Nydalen, Oslo, N-0426, Norway
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Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med 2013; 10:e1001362. [PMID: 23349621 PMCID: PMC3548655 DOI: 10.1371/journal.pmed.1001362] [Citation(s) in RCA: 1049] [Impact Index Per Article: 95.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 11/16/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes.
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Affiliation(s)
- Caroline Free
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK.
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Park SO, Hong CK, Shin DH, Lee JH, Hwang SY. Efficacy of metronome sound guidance via a phone speaker during dispatcher-assisted compression-only cardiopulmonary resuscitation by an untrained layperson: a randomised controlled simulation study using a manikin. Emerg Med J 2012; 30:657-61. [PMID: 23018287 DOI: 10.1136/emermed-2012-201612] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM Untrained laypersons should perform compression-only cardiopulmonary resuscitation (COCPR) under a dispatcher's guidance, but the quality of the chest compressions may be suboptimal. We hypothesised that providing metronome sounds via a phone speaker may improve the quality of chest compressions during dispatcher-assisted COCPR (DA-COCPR). METHODS Untrained laypersons were allocated to either the metronome sound-guided group (MG), who performed DA-COCPR with metronome sounds (110 ticks/min), or the control group (CG), who performed conventional DA-COCPR. The participants of each group performed DA-COCPR for 4 min using a manikin with Skill-Reporter, and the data regarding chest compression quality were collected. RESULTS The data from 33 cases of DA-COCPR in the MG and 34 cases in the CG were compared. The MG showed a faster compression rate than the CG (111.9 vs 96.7/min; p=0.018). A significantly higher proportion of subjects in the MG performed the DA-COCPR with an accurate chest compression rate (100-120/min) compared with the subjects in the CG (32/33 (97.0%) vs 5/34 (14.7%); p<0.0001). The mean compression depth was not different between the MG and the CG (45.9 vs 46.8 mm; p=0.692). However, a higher proportion of subjects in the MG performed shallow compressions (compression depth <38 mm) compared with subjects in the CG (median % was 69.2 vs 15.7; p=0.035). CONCLUSIONS Metronome sound guidance during DA-COCPR for the untrained bystanders improved the chest compression rates, but was associated more with shallow compressions than the conventional DA-COCPR in a manikin model.
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Affiliation(s)
- Sang O Park
- Department of Emergency Medicine, Konkuk University School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
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Thygerson SM, West JH, Rassbach AR, Thygerson AL. iPhone Apps for First Aid: A Content Analysis. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2012. [DOI: 10.1080/15398285.2012.673465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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External chest compressions using a mechanical feedback device. Anaesthesist 2011; 60:717-22. [DOI: 10.1007/s00101-011-1871-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 02/10/2011] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
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Mochmann HC. Lebensbedrohliche Herzrhythmusstörungen. Notf Rett Med 2011. [DOI: 10.1007/s10049-010-1328-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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