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

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) 目的：探討智能手機應用程式實時反饋對 CPR 表現的影響。方法：受試者根據是否使用智能手機應用程 式幫助胸部按壓隨機分為兩組。兩組在人體模型進行心肺復甦術 4 分鐘。比較兩組的 CPR 表現數據。為 了評估反饋的可靠性，我們比較了 Skillmeter 和智能手機的 CPR 數據。以問卷調查，了解參與者對應用 程式實用性的評價。結果：二十一受試者納入研究。我們發現兩組之間在平均胸部按壓率（ 103

Effectiveness of chest compression feedback during cardiopulmonary resuscitation in lateral tilted and semirecumbent positions: a randomised controlled simulation study

“…Recently, applications (apps) designed for smartphones with a built‐in accelerometer have been developed for CPR training with chest compression feedback . Several simulation studies have found that these can improve performance of chest compression and might therefore substitute for commercial feedback devices . These studies were conducted while the manikin was supine.…”

Part 8: Education, Implementation, and Teams

“…Heterogeneous reporting prevented some meta-analyses. There were 23 directive feedback studies 50,[191][192][193][194][195][196][197][198][199][200][201][202][203][204][205][206][207][212][213][214][215][216] showing that in comparison with no feedback devices, the use of feedback devices…”

Effect of smart devices on the quality of CPR training: A systematic review

“…9,10,[15][16][17][18][19][20][21][22][23] Study characteristics Table 1shows the characteristics of the selected studies. The studies included five RCTs (45%), 9,16,19,22,23 five RCOTs (45%), 10,15,18,20,21 and an RT (9%). 17 Eight of 11 studies (73%) used smartphones 9,10,15-20 and 3 studies (27%) [21][22][23] used smartwatches for their CPR training intervention.…”

“…Five studies (45%) were rated as 'of some concern' or 'high' for this domain due to the lack of detailed information on the actual randomisation process used. 10,15,17,18,21 Second, 'bias due to deviation from intended intervention' was evaluated. Five RCTs/RTs (45%) were rated as 'of some concern' since they did not clearly comment on blinding to intervention.…”

“…There have been various studies conducted to show the usefulness of smart devices as CPR feedback devices, but the results have been conflicting thus far. 9,10,[15][16][17][18][19][20][21][22][23] This systematic review aimed to examine randomised trials to determine if smart devices used during CPR training could improve the quality of CPR. Additionally, we investigated what type of smart device, phone or watch, was more effective at improving CPR quality.…”