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

Abstract

Aim of the review: Use of smart devices to provide real-time cardiopulmonary resuscitation (CPR) feedback in the context of out-of-hospital cardiac arrest (OHCA) has considerable potential for improving survival. However, the findings of previous studies evaluating the effectiveness of these devices have been conflicting. Therefore, we conducted a systematic review of the literature to assess the utility of smart devices for improving the quality of CPR during CPR training.Data sources: Thirteen electronic databases were searched. The articles were reviewed according to the eligibility criteria. CPR quality was evaluated based on the rates and depths of chest compression, and the proportion of adequate depth of chest compressions.Results: Ultimately, 11 studies (5 randomised controlled trials, 1 randomised trial, and 5 randomised cross-over trials) were selected for this systematic review. Eight of these studies used smartphones and three used smartwatches. This review did not find an apparent benefit from smart device use during CPR in terms of maintaining the recommended compression rates and depths of chest compressions. However, all three smartwatch studies reported that the proportion of chest compressions of adequate depth was significantly improved with smartwatch use (smartwatch group vs. nonsmartwatch group in the three studies: 65.01% vs. 45.15%, p = 0.01; 64.6% vs. 43.1%, p = 0.049; 98.7% vs. 79.3%, p = 0.002).Conclusion: This review does not find durable evidence for usefulness of smart devices in CPR training. However, the smartwatches may improve the accuracy of chest compression depth. Future studies with larger sample sizes might be necessary before reaching a firm conclusion.

Impact of a Smart-Ring-Based Feedback System on the Quality of Chest Compressions in Adult Cardiac Arrest: A Randomized Preliminary Study

“…CPR feedback systems using various smart devices have been studied over the past decade. A previous meta-analysis [ 23 ] included 11 such studies; three of them involved smartwatch-based feedback [ 14 , 15 , 16 ]. For example, Park showed that smartphone-based feedback did not improve the quality of CPR and that the hand pain associated with holding and operating a smartphone was a reason for complaint [ 24 ].…”

Basic life support knowledge in Germany and the influences of demographic factors

“…However, these pilot programs have to be carefully evaluated because relevant factors for designing farreaching community CPR training programs are not well defined. In this context, smartphone applications might also be helpful in future CPR trainings [25][26][27][28].…”

The types and effects of feedback received by emergency ambulance staff: protocol for a systematic mixed studies review with narrative synthesis

“…For example, there is a growing body of research on automated audio-visual feedback provided by defibrillators utilised during cardiopulmonary resuscitation. Systematic reviews by Yeung et al (2009) and An et al (2019), as well as meta-analyses by Kirkbright et al (2014) and Wang et al (2020), already synthesise the evaluative evidence in this area, demonstrating that audiovisual feedback during resuscitation can result in better adherence to recommended chest compression rate and depth, as well as improved patient outcomes depending on the type of device used.…”

“…For example, there is a growing body of research on automated audiovisual feedback provided by defibrillators utilised during cardiopulmonary resuscitation. Systematic reviews by Yeung et al (2009) and An et al (2019), as well as meta-analyses by Kirkbright et al (2014) and Wang et al (2020), already synthesise the evaluative evidence in this area, demonstrating that audiovisual feedback during resuscitation can result in better adherence to Author (year) Contribution Hysong ( 2009) (1) Audit and feedback has a modest, though significant positive effect on quality outcomes (2) Feedback seems more effective when delivered frequently in writing and with specific suggestions for improvement de Vos et al (2009) (1) Feedback seems most effective when given in combination with an education implementation strategy and/or the development of a quality improvement plan van Der Veer et al…”