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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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Wetsch WA, Ecker HM, Scheu A, Roth R, Böttiger BW, Plata C. Video-assisted cardiopulmonary resuscitation: Does the camera perspective matter? A randomized, controlled simulation trial. J Telemed Telecare 2024; 30:98-106. [PMID: 34170206 DOI: 10.1177/1357633x211028490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dispatcher assistance can help to save lives during layperson cardiopulmonary resuscitation during cardiac arrest. The aim of this study was to investigate the influence of different camera positions on the evaluation of cardiopulmonary resuscitation performance during video-assisted cardiopulmonary resuscitation. METHODS For this randomized, controlled simulation trial, seven video sequences of cardiopulmonary resuscitation performance were recorded from three different camera positions: side, foot and head position. Video sequences showed either correct cardiopulmonary resuscitation performance or one of the six typical errors: low and high compression rate, superficial and increased compression depth, wrong hand position or incomplete release. Video sequences with different cardiopulmonary resuscitation performances and camera positions were randomly combined such that each evaluator was presented seven individual combinations of cardiopulmonary resuscitation and camera position and evaluated each cardiopulmonary resuscitation performance once. A total of 46 paramedics and 47 emergency physicians evaluated seven video sequences of cardiopulmonary resuscitation performance from different camera positions. The primary hypothesis was that there are differences in accuracy of correct assessment/error recognition depending on camera perspective. Generalized linear multi-level analyses assuming a binomial distribution and a logit link were employed to account for the dependency between each evaluator's seven ratings. RESULTS Of 651 video sequences, cardiopulmonary resuscitation performance was evaluable in 96.8% and correctly evaluated in 74.5% over all camera positions. Cardiopulmonary resuscitation performance was classified correctly from a side perspective in 81.3%, from a foot perspective in 68.8% and from a head perspective in 73.6%, revealing a significant difference in error recognition depending on the camera perspective (p = .01). Correct cardiopulmonary resuscitation was mistakenly evaluated to be false in 46.2% over all perspectives. CONCLUSIONS Participants were able to recognize significantly more mistakes when the camera was located on the opposite side of the cardiopulmonary resuscitation provider. Foot position should be avoided in order to enable the dispatcher the best possible view to evaluating cardiopulmonary resuscitation quality.
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Affiliation(s)
- Wolfgang A Wetsch
- Faculty of Medicine, University of Cologne, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany
| | - Hannes M Ecker
- Faculty of Medicine, University of Cologne, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany
| | - Alexander Scheu
- Faculty of Medicine, University of Cologne, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany
| | - Rebecca Roth
- Faculty of Medicine, University of Cologne, Germany
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Germany
| | - Bernd W Böttiger
- Faculty of Medicine, University of Cologne, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany
| | - Christopher Plata
- Faculty of Medicine, University of Cologne, Germany
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany
- Emergency Department, University Hospital RWTH Aachen, Germany
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Szöllősi V, Horváth B, Németh D, Bánfai-Csonka H, Betlehem J, Bánfai B. A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students. Sci Rep 2023; 13:14925. [PMID: 37696968 PMCID: PMC10495456 DOI: 10.1038/s41598-023-42131-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
Our randomized controlled simulation study aimed to compare the CPR quality, time-related factors, attitude and self-assessment of non-healthcare university students (aged 18-25) compared video-assisted (V-CPR, n = 50) with telephone-assisted (T-CPR, n = 49) and unassisted (U-CPR, n = 48) CPR in a simulation setting. Regarding to chest compression depth, no difference was found between the three groups (p = 0.065): 41.8 mm, SD = 9.9 in the V-CPR; 35.9 mm, SD = 11.6 in the T-CPR; and 39.4 mm, SD = 15.6 in the U-CPR group. The mean chest compression rate was the best in the V-CPR group (100.9 min-1, SD = 17.1) which was superior to the T-CPR (82.4 min-1, SD = 35.4; p = 0.005), and the U-CPR (84.2 min-1, SD = 30.6; p = 0.013) groups. The overall proportion of correct hand position was the highest in the V-CPR group (48, 96%), compared to the T-CPR (28, 57.1%; p = 0.001), and the U-CPR (34, 70.8%; p = 0.001) groups. V-CPR led to a delay in the time to the first chest compression compared with the U-CPR group (77.5 s, SD = 19.2 vs. 31.3 s, SD = 13.3, p < 0.001). Although V-CPR technology holds the potential to improve overall CPR quality, the importance of appropriate chest compression depth should be emphasized in training for laypeople and dispatchers, as well. Our study was registered at ClinicalTrials.gov (NCT05639868, 06/12/2022).
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Affiliation(s)
- Vivien Szöllősi
- Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary
- National Ambulance Service, Szombathely, Hungary
| | - Balázs Horváth
- National Ambulance Service, Szombathely, Hungary
- Doctoral School of Health Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary
| | | | - Henrietta Bánfai-Csonka
- Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary
- Doctoral School of Health Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary
- Department of Emergency Medicine, Clinical Centre, University of Pécs, Ifjúság Street 13., 7624, Pécs, Hungary
| | - József Betlehem
- Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary
| | - Bálint Bánfai
- Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs Faculty of Health Sciences, Vörösmarty Street 4, 7621, Pécs, Hungary.
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Barcala-Furelos R, Aranda-García S, Otero-Agra M, Fernández-Méndez F, Alonso-Calvete A, Martínez-Isasi S, Greif R, Rodríguez-Núñez A. Are smart glasses feasible for dispatch prehospital assistance during on-boat cardiac arrest? A pilot simulation study with fishermen. Intern Emerg Med 2023; 18:1551-1559. [PMID: 37014496 PMCID: PMC10412669 DOI: 10.1007/s11739-023-03251-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/02/2023] [Indexed: 04/05/2023]
Abstract
The aim of the study was to explore feasibility of basic life support (BLS) guided through smart glasses (SGs) when assisting fishermen bystanders. Twelve participants assisted a simulated out-of-hospital cardiac arrest on a fishing boat assisted by the dispatcher through the SGs. The SGs were connected to make video calls. Feasibility was assessed whether or not they needed help from the dispatcher. BLS-AED steps, time to first shock/compression, and CPR's quality (hands-only) during 2 consecutive minutes (1st minute without dispatcher feedback, 2nd with dispatcher feedback) were analyzed. Reliability was analyzed by comparing the assessment of variables performed by the dispatcher through SGs with those registered by an on-scene instructor. Assistance through SGs was needed in 72% of the BLS steps, which enabled all participants to perform the ABC approach and use AED correctly. Feasibility was proven that dispatcher's feedback through SGs helped to improve bystanders' performance, as after dispatcher gave feedback via SGs, only 3% of skills were incorrect. Comparison of on-scene instructor vs. SGs assessment by dispatcher differ in 8% of the analyzed skills: greatest difference in the "incorrect hand position during CPR" (on-scene: 33% vs. dispatcher: 0%). When comparing the 1st minute with 2nd minute, there were only significant differences in the percentage of compressions with correct depth (1st:48 ± 42%, 2nd:70 ± 31, p = 0.02). Using SGs in aquatic settings is feasible and improves BLS. CPR quality markers were similar with and without SG. These devices have great potential for communication between dispatchers and laypersons but need more development to be used in real emergencies.
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Affiliation(s)
- Roberto Barcala-Furelos
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- CLINURSID Research Group, School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Silvia Aranda-García
- CLINURSID Research Group, School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
- GRAFAIS Research Group, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Av. De l'Estadi 22, 08038, Barcelona, Spain.
| | - Martín Otero-Agra
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- School of Nursing from Pontevedra, Universidade de Vigo, Pontevedra, Spain
| | - Felipe Fernández-Méndez
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- CLINURSID Research Group, School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Life Support and Medical Simulation Research Group (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- School of Nursing from Pontevedra, Universidade de Vigo, Pontevedra, Spain
| | - Alejandra Alonso-Calvete
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, Pontevedra, Spain
- Faculty of Physiotherapy, Universidade de Vigo, Pontevedra, Spain
| | - Santiago Martínez-Isasi
- CLINURSID Research Group, School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Life Support and Medical Simulation Research Group (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, School of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Life Support and Medical Simulation Research Group (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Nursing, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Paediatric Critical, Intermediate and Palliative Care Section, Santiago de Compostela's University Hospital, Santiago de Compostela, Spain
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Hölzing CR, Brinkrolf P, Metelmann C, Metelmann B, Hahnenkamp K, Baumgarten M. Potential to enhance telephone cardiopulmonary resuscitation with improved instructions - findings from a simulation-based manikin study with lay rescuers. BMC Emerg Med 2023; 23:36. [PMID: 37003971 PMCID: PMC10067171 DOI: 10.1186/s12873-023-00810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Telephone-Cardiopulmonary Resuscitation (T-CPR) significantly increases rate of bystander resuscitation and improves patient outcomes after out-of-hospital cardiac arrest (OHCA). Nevertheless, securing correct execution of instructions remains a difficulty. ERC Guidelines 2021 recommend standardised instructions with continuous evaluation. Yet, there are no explicit recommendations on a standardised wording of T-CPR in the German language. We investigated, whether a modified wording regarding check for breathing in a German T-CPR protocol improved performance of T-CPR. METHODS A simulation study with 48 OHCA scenarios was conducted. In a non-randomised trial study lay rescuers were instructed using the real-life-CPR protocol of the regional dispatch centre and as the intervention a modified T-CPR protocol, including specific check for breathing (head tilt-chin lift instructions). Resuscitation parameters were assessed with a manikin and video recordings. RESULTS Check for breathing was performed by 64.3% (n = 14) of the lay rescuers with original wording and by 92.6% (n = 27) in the group with modified wording (p = 0.035). In the original wording group the head tilt-chin manoeuvre was executed by 0.0% of the lay rescuers compared to 70.3% in the group with modified wording (p < 0.001). The average duration of check for breathing was 1 ± 1 s in the original wording group and 4 ± 2 s in the group with modified wording (p < 0.001). Other instructions (e.g. check for consciousness and removal of clothing) were well performed and did not differ significantly between groups. Quality of chest compression did not differ significantly between groups, with the exception of mean chest compression depth, which was slightly deeper in the modified wording group. CONCLUSION Correct check for breathing seems to be a problem for lay rescuers, which can be decreased by describing the assessment in more detail. Hence, T-CPR protocols should provide standardised explicit instructions on how to perform airway assessment. Each protocol should be evaluated for practicability.
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Affiliation(s)
- Carlos Ramon Hölzing
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany.
| | - Peter Brinkrolf
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany
| | - Camilla Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany
| | - Bibiana Metelmann
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany
| | - Klaus Hahnenkamp
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany
| | - Mina Baumgarten
- Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany
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Video Emergency Calls in Medical Dispatching: A Scoping Review. Prehosp Disaster Med 2022; 37:819-826. [PMID: 36138554 DOI: 10.1017/s1049023x22001297] [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: 12/14/2022]
Abstract
BACKGROUND Video emergency calls (VCs) represent a feasible future trend in medical dispatching. Acceptance among callers and dispatchers seems to be good. Indications, potential problems, limitations, and directions of research of adding a live video from smartphones to an emergency call have not been reviewed outside the context of out-of-hospital cardiac arrest (OHCA). OBJECTIVE The main objective of this study is to examine the scope and nature of research publications on the topic of VC. The secondary goal is to identify research gaps and discuss the potential directions of research efforts of VC. DESIGN Following PRISMA-ScR guidelines, online bibliographic databases PubMed, Web of Science, SCOPUS, Google Scholar, ClinicalTrials.gov, and gray literature were searched from the period of January 1, 2012 through March 1, 2022 in English. Only studies focusing on video transfer via mobile phone to emergency medical dispatch centers (EMDCs) were included. RESULTS Twelve articles were included in the qualitative synthesis and six main themes were identified: (1) cardiopulmonary resuscitation (CPR) guided by VC; (2) indications of VCs; (3) dispatchers' feedback and perception; (4) technical aspects of VCs; (5) callers' acceptance; and (6) confidentiality and legal issues. CONCLUSION Video emergency calls are feasible and seem to be a well-accepted auxiliary method among dispatchers and callers. Some promising clinical results exist, especially for video-assisted CPR. On the other hand, there are still enormous knowledge gaps in the vast majority of implementation aspects of VC into practice.
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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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8
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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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9
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Igarashi Y, Norii T, Sung‐Ho K, Nagata S, Yoshino Y, Hamaguchi T, Nagaosa R, Nakao S, Tagami T, Yokobori S. Airway obstruction time and outcomes in patients with foreign body airway obstruction: multicenter observational choking investigation. Acute Med Surg 2022; 9:e741. [PMID: 35309267 PMCID: PMC8918414 DOI: 10.1002/ams2.741] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/03/2022] [Accepted: 02/18/2022] [Indexed: 11/26/2022] Open
Abstract
Aim Foreign body airway obstruction (FBAO) is a major public health concern worldwide for infants and older adults. This study determines the association between airway obstruction time and neurological outcomes to plan an effective response for patients with FBAO. Methods This multicenter retrospective observational study was carried out among patients with life‐threatening FBAO in Japan over a period of 4 years. The duration of airway obstruction was calculated from the time of the accident to the time of foreign body removal. The study examined the relationship between airway obstruction time and outcome. The primary outcome was vegetative state or death at hospital discharge. Results Among 119 patients, 68 were in the category of vegetative state or death. Logistic regression analysis showed that longer airway obstruction time (adjusted odds ratio 1.04; 95% confidence interval 1.01–1.07) was associated with vegetative state or death. When the cut‐off value was set at 10, the sensitivity was 0.88, the specificity 0.47, with the area under the curve 0.69. Using the other cut‐off value of 4 min, the negative predictive value was 1.00. Conclusion Longer airway obstruction time was associated with vegetative state or death for patients with FBAO. The incidence of vegetative state or death increased when the airway obstruction time exceeded 10 min. Meanwhile, 4 min or less may be set as a target time for foreign body removal in order to prevent vegetative state or death and plan an effective response.
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Affiliation(s)
- Yutaka Igarashi
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Tatsuya Norii
- Department of Emergency Medicine University of New Mexico Albuquerque New Mexico USA
- Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Kim Sung‐Ho
- Senshu Trauma and Critical Care Center Rinku General Medical Center Osaka Japan
| | - Shimpei Nagata
- Department of Clinical Epidemiology and Health Economics The University of Tokyo Tokyo Japan
| | - Yudai Yoshino
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
- Department of Emergency and Critical Care Medicine Nippon Medical School Musashi Kosugi Hospital Kanagawa Japan
| | - Takuro Hamaguchi
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Riko Nagaosa
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
- Department of Emergency and Critical Care Medicine Nippon Medical School Musashi Kosugi Hospital Kanagawa Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
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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: 60] [Impact Index Per Article: 20.0] [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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12
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Linderoth G, Rosenkrantz O, Lippert F, Østergaard D, Ersbøll AK, Meyhoff CS, Folke F, Christensen HC. Live video from bystanders' smartphones to improve cardiopulmonary resuscitation. Resuscitation 2021; 168:35-43. [PMID: 34509558 DOI: 10.1016/j.resuscitation.2021.08.048] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
AIM To investigate whether live video streaming from the bystander's smartphone to a medical dispatcher can improve the quality of bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA). METHODS After CPR was initiated, live video was added to the communication by the medical dispatcher using smartphone technology. From the video recordings, we subjectively evaluated changes in CPR quality after themedical dispatcher had used live video to dispatcher-assisted CPR (DA-CPR). CPR quality was registered for each bystander and compared with CPR quality after video-instructed DA-CPR. Data were analysed using logistic regression adjusted for bystander's relation to the patient and whether the arrest was witnessed. RESULTS CPR was provided with live video streaming in 52 OHCA calls, with 90 bystanders who performed chest compressions. Hand position was incorrect for 38 bystanders (42.2%) and improved for 23 bystanders (60.5%) after video-instructed DA-CPR. The compression rate was incorrect for 36 bystanders (40.0%) and improved for 27 bystanders (75.0%). Compression depth was incorrect for 57 bystanders (63.3%) and improved for 33 bystanders (57.9%). The adjusted odds ratios for improved CPR after video-instructed DA-CPR were; hand position 5.8 (95% CI: 2.8-12.1), compression rate 7.7 (95% CI: 3.4-17.3), and compression depth 7.1 (95% CI: 3.9-12.9). Hands-off time was reduced for 34 (37.8%) bystanders. CONCLUSIONS Live video streaming from the scene of a cardiac arrest to medical dispatchers is feasible. It allowed an opportunity for dispatchers to coach those providing CPR which was associated with a subjectively evaluated improvement in CPR performance.
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Affiliation(s)
- Gitte Linderoth
- Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Oscar Rosenkrantz
- Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark
| | - Freddy Lippert
- Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Doris Østergaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Copenhagen Academy for Medical Education and Simulation, CAMES, Copenhagen University Hospital - Herlev, Copenhagen, Denmark
| | - Annette K Ersbøll
- National Institute for Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christian S Meyhoff
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Gentofte, Copenhagen, Denmark
| | - Helle C Christensen
- Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Danish Clinical Quality Program (RKKP) ▪ National Clinical Registries, Copenhagen, Denmark
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Plata C, Nellessen M, Roth R, Ecker H, Böttiger BW, Löser J, Wetsch WA. Impact of video quality when evaluating video-assisted cardiopulmonary resuscitation: a randomized, controlled simulation trial. BMC Emerg Med 2021; 21:96. [PMID: 34418968 PMCID: PMC8380108 DOI: 10.1186/s12873-021-00486-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 07/26/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although not routinely established during cardiopulmonary resuscitation (CPR), video-assisted CPR has been described as beneficial in the communication with emergency medical service (EMS) authorities in out-of-hospital cardiac arrest scenarios. Since the influence of video quality has not been investigated systematically and due to variation of quality of a live-stream video during video-assisted CPR, we investigated the influence of different video quality levels during the evaluation of CPR performance in video sequences. METHODS Seven video sequences of CPR performance were recorded in high quality and artificially reduced to medium and low quality afterwards. Video sequences showed either correct CPR performance or one of six typical errors: too low and too high compression rate, superficial and increased compression depth, wrong hand position and incomplete release. Video sequences were randomly assigned to the different quality levels. During the randomised and double-blinded evaluation process, 46 paramedics and 47 emergency physicians evaluated seven video sequences of CPR performance in different quality levels (high, medium and low resolution). RESULTS Of 650 video sequences, CPR performance was evaluable in 98.2%. CPR performance was correctly evaluated in 71.5% at low quality, in 76.8% at medium quality, and in 77.3% at high quality level, showing no significant differences depending on video quality (p = 0.306). In the subgroup analysis, correct classification of increased compression depth showed significant differences depending on video quality (p = 0.006). Further, there were significant differences in correct CPR classification depending on the presented error (p < 0.001). Allegedly errors, that were not shown in the video sequence, were classified in 28.3%, insignificantly depending on video quality. Correct evaluation did not show significant interprofessional differences (p = 0.468). CONCLUSION Video quality has no significant impact on the evaluation of CPR in a video sequence. Even low video quality leads to an acceptable rate of correct evaluation of CPR performance. There is a significant difference in evaluation of CPR performance depending on the presented error in a video sequence. TRIAL REGISTRATION German Clinical Trial Register (Registration number DRKS00015297 ) Registered on 2018-08-21.
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Affiliation(s)
- Christopher Plata
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany.,Emergency Department, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Martin Nellessen
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Rebecca Roth
- University of Cologne, Faculty of Medicine, and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Hannes Ecker
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Bernd W Böttiger
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Johannes Löser
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Centre of Palliative Medicine, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Wolfgang A Wetsch
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937, Cologne, Germany.
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Alem L, Bacqué J, Guihenneuc J, Delelis-Fanien H, Mimoz O, Migeot V. Quality indicators development and prioritisation for emergency medical call centres: a stakeholder consensus. BMJ Open Qual 2021; 10:bmjoq-2020-001176. [PMID: 34035128 PMCID: PMC8154933 DOI: 10.1136/bmjoq-2020-001176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/28/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Emergency medical regulation is a risky activity. In France, emergency medical societies have proposed activity and performance indicators, but their lists are non-exhaustive, unstructured and used heterogeneously among emergency medical call centres (Centres de Réception et de Régulation des Appels, CRRA). Our objective was to build by means of regional stakeholder consensus an operational quality dashboard for CRRAs. Methods We conducted an observational step in a French CRRA from June to September 2018 and at the same time listed existing activity and quality indicators through a rapid international literature review. We adapted and classified all indicators identified in a structured table. We prioritised them from April to September 2019 by seeking consensus with one regulator physician and one medical regulation assistant from the 13 CRRAs of the largest French region. We used an adapted Delphi method with a prioritisation scale from 1 to 9. Results The rapid review of literature included 33 studies among the 414 identified and, with the first observational step, resulted in a list of 360 quality indicators covering the following areas: material resources, human resources, quality approach, call handling and postcall support. 15 of the 26 members participated in the entire process. Seventy indicators were considered as priorities with strong agreement among participants. We built an operational dashboard of quality indicators deemed high priority and provided 70 descriptive indicator sheets. Conclusion Our study allowed to build an operational quality dashboard for CRRAs as a ready-to-use support for an internal audit, for prioritisation of quality approach actions and for national and international benchmarking.
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Affiliation(s)
- Lucie Alem
- Public Health Department, University Hospital Centre, Poitiers, France
| | - Julie Bacqué
- Emergency Department, University Hospital Centre, Poitiers, France
| | - Jérémy Guihenneuc
- Public Health Department, University Hospital Centre, Poitiers, France
| | | | - Olivier Mimoz
- Emergency Department, University Hospital Centre, Poitiers, France.,Medicine and Pharmacy, University of Poitiers, Poitiers, France
| | - Virginie Migeot
- Public Health Department, University Hospital Centre, Poitiers, France.,Medicine and Pharmacy, University of Poitiers, Poitiers, France
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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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Varma N, Cygankiewicz I, Turakhia MP, Heidbuchel H, Hu YF, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini JP, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society. Circ Arrhythm Electrophysiol 2021; 14:e009204. [PMID: 33573393 PMCID: PMC7892205 DOI: 10.1161/circep.120.009204] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Supplemental Digital Content is available in the text. This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society describes the current status of mobile health technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mobile health. The promises of predictive analytics but also operational challenges in embedding mobile health into routine clinical care are explored.
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Affiliation(s)
- Niraj Varma
- Cleveland Clinic, OH (N.V., J.D.E., R.M., R.E.R.)
| | | | | | | | - Yu-Feng Hu
- Taipei Veterans General Hospital, Taiwan (Y.-F.H.)
| | | | | | | | | | | | | | - Reena Mehra
- Cleveland Clinic, OH (N.V., J.D.E., R.M., R.E.R.)
| | - Alex Page
- University of Rochester, NY (J.-P.C., A.P., J.S.S.)
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL (R. Passman)
| | | | - Ewa Piotrowicz
- National Institute of Cardiology, Warsaw, Poland (E.P., R. Piotrowicz)
| | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (A.L.R.)
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ (A.M.R.)
| | - David Slotwiner
- Cardiology Division, New York-Presbyterian Queens, NY (D.S.)
| | | | - Emma Svennberg
- Karolinska University Hospital, Stockholm, Sweden (E.S.)
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2021 ISHNE/HRS/EHRA/APHRS Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2021; 2:4-54. [PMID: 35265889 PMCID: PMC8890358 DOI: 10.1016/j.cvdhj.2020.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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18
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. Ann Noninvasive Electrocardiol 2021; 26:e12795. [PMID: 33513268 PMCID: PMC7935104 DOI: 10.1111/anec.12795] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/ Heart Rhythm Society/ European Heart Rhythm Association/ Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
| | | | | | - Hein Heidbuchel
- Antwerp University and University Hospital, Antwerp, Belgium
| | - Yufeng Hu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester, Rochester, NY, USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - David Slotwiner
- Cardiology Division, NewYork-Presbyterian Queens, and School of Health Policy and Research, Weill Cornell Medicine, New York, NY, USA
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc JP, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society. J Arrhythm 2021; 37:271-319. [PMID: 33850572 PMCID: PMC8022003 DOI: 10.1002/joa3.12461] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023] Open
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health (“mHealth”) technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self‐management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
| | | | | | | | - Yufeng Hu
- Taipei Veterans General Hospital Taipei Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester Rochester NY USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina Centro de Telessaúde Hospital das Clínicas and Departamento de Clínica Médica Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | | | - David Slotwiner
- Cardiology Division NewYork-Presbyterian Queens and School of Health Policy and Research Weill Cornell Medicine New York NY USA
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Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, Couderc J, Cronin EM, Estep JD, Grieten L, Lane DA, Mehra R, Page A, Passman R, Piccini J, Piotrowicz E, Piotrowicz R, Platonov PG, Ribeiro AL, Rich RE, Russo AM, Slotwiner D, Steinberg JS, Svennberg E. 2021 ISHNE / HRS / EHRA / APHRS Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology / Heart Rhythm Society / European Heart Rhythm Association / Asia Pacific Heart Rhythm Society. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:7-48. [PMID: 36711170 PMCID: PMC9708018 DOI: 10.1093/ehjdh/ztab001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology / Heart Rhythm Society / European Heart Rhythm Association / Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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Affiliation(s)
- Niraj Varma
- Cleveland Clinic, Cleveland, OH, USA,Correspondence: Niraj Varma, Cleveland Clinic, Cleveland, OH, USA.
| | | | | | - Hein Heidbuchel
- Antwerp University and University Hospital, Antwerp, Belgium
| | - Yufeng Hu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | | - Alex Page
- University of Rochester, Rochester, NY, USA
| | - Rod Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Antonio Luiz Ribeiro
- Faculdade de Medicina, Centro de Telessaúde, Hospital das Clínicas, and Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - David Slotwiner
- Cardiology Division, NewYork-Presbyterian Queens, and School of Health, Policy and Research, Weill Cornell Medicine, New York, NY, USA
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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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Ecker H, Wingen S, Hamacher S, Lindacher F, Böttiger BW, Wetsch WA. Evaluation Of CPR Quality Via Smartphone With A Video Livestream – A Study In A Metropolitan Area. PREHOSP EMERG CARE 2020; 25:76-81. [DOI: 10.1080/10903127.2020.1734122] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Perry O, Wacht O, Jaffe E, Sinuany-Stern Z, Bitan Y. Using a filming protocol to improve video-instructed cardiopulmonary resuscitation. Technol Health Care 2020; 28:213-220. [PMID: 31958102 PMCID: PMC7175934 DOI: 10.3233/thc-192024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND: Video communications during cardiopulmonary resuscitation (CPR) can improve the quality of information exchange between a bystander performing CPR and an emergency medical dispatcher (EMD). OBJECTIVE: To improve chest compression effectiveness, a filming protocol instructing video camera placements around a patient was developed. This study measured whether the filming protocol increased chest compressions’ effectiveness. METHODS: A simulation study was conducted comparing CPR effectiveness under three conditions: telephone-instructed, video-instructed, and video-instructed with the filming protocol. Twenty-five emergency medical technicians acted as EMDsin the three conditions. A mannequin measured five factors that determined the effectiveness of the chest compressions. RESULTS: Compared with telephone-instructed CPR, the filming protocol improved the proportion of time in which the bystander’s hands were in the correct position during chest compressions. Compared with video-instructed CPR, the filming protocol improved both the proportion of time in which the chest was fully released after each compression and the proportion of time in which the compressions were conducted with an appropriate rhythm. The depth and rate of compressions did not improve in the filming protocol condition. CONCLUSIONS: Video-instructed CPR with the filming protocol improves CPR effectiveness compared to telephone- and video-instructed CPR. Detailed implementation can improve new technology introduction.
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Affiliation(s)
- Omer Perry
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oren Wacht
- Department of Emergency Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Magen-David-Adom (Israel National Emergency Medical Service), Israel
| | - Eli Jaffe
- Department of Emergency Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Magen-David-Adom (Israel National Emergency Medical Service), Israel
| | - Zilla Sinuany-Stern
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yuval Bitan
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Comparison of the effects of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation on resuscitation outcomes after out-of-hospital cardiac arrest. Resuscitation 2019; 147:12-20. [PMID: 31843537 DOI: 10.1016/j.resuscitation.2019.12.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/18/2019] [Accepted: 12/01/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND This study compared the real-world effects of audio-instructed dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) and video-instructed DA-CPR on resuscitation outcomes after out-of-hospital cardiac arrest (OHCA). METHODS A retrospective cohort study was conducted among adult OHCA patients in whom resuscitation was attempted in 2017 in Seoul, Korea. The dispatch center of Seoul introduced video-instructed DA-CPR in 2017, whereas audio-instructed DA-CPR was first implemented in 2010. When more than two bystanders were at the scene and could handle a video-call, the dispatcher call back a video-call and provided CPR instructions. In other situations, standard audio-instructed DA-CPR was provided. The primary outcome was survival to discharge. The secondary outcome was good neurological outcome at hospital discharge. The tertiary outcome was early instruction time interval (ITI, time from call to the initiation of CPR instruction ≤90 s). The study outcomes of audio-instructed DA-CPR (audio group) and video-instructed DA-CPR (video group) were compared. The propensity score matching (PSM) method was used to increase the comparability of the two groups and the logistic regression was performed for the PSM cohort. RESULTS A total of 1720 eligible OHCA patients (1489 and 231 in the audio and video groups, respectively) were evaluated. The median ITI was 136 s in the audio group and 122 s in the video group (p = 0.12). The survival to discharge rates were 8.9% in the audio group and 14.3% in the video groups (p < 0.01). Good neurological outcome occurred in 5.8% and 10.4% in the audio and video groups, respectively (p < 0.01). Compared to the audio group, the AORs (95% CIs) for survival to discharge, good neurological outcome and early ITI of the video group were 1.20 (0.74-1.94), 1.28 (0.73-2.26) and 1.00 (0.70-1.43), respectively. The PSM population showed similar results as those of the original cohort. CONCLUSION Compared to audio-instructed DA-CPR, video-instructed DA-CPR was not associated with survival improvement in this observational study conducted in one metropolitan city. Randomized controlled trials are needed to compare the effects of video- and audio-instructed DA-CPR.
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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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Linderoth G, Møller TP, Folke F, Lippert FK, Østergaard D. Medical dispatchers' perception of visual information in real out-of-hospital cardiac arrest: a qualitative interview study. Scand J Trauma Resusc Emerg Med 2019; 27:8. [PMID: 30683139 PMCID: PMC6347804 DOI: 10.1186/s13049-018-0584-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/28/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Gitte Linderoth
- Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, DK-2750, Copenhagen, Denmark. .,Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400, Copenhagen, NV, Denmark.
| | - Thea Palsgaard Møller
- Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, DK-2750, Copenhagen, Denmark
| | - Fredrik Folke
- Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, DK-2750, Copenhagen, Denmark
| | - Freddy K Lippert
- Emergency Medical Services Copenhagen, University of Copenhagen, Telegrafvej 5, DK-2750, Copenhagen, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, University of Copenhagen, Herlev Ringvej 75, DK-2730, Herlev, Denmark
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Kalu QN, Oku OO, Ilori IAU. Establishing Cardiopulmonary Resuscitation Services in Sub-Saharan Africa: A Survey of Suggestions Made by Health Care Workers in Cross River State, Nigeria. Open Access Maced J Med Sci 2018; 6:944-948. [PMID: 29875877 PMCID: PMC5985863 DOI: 10.3889/oamjms.2018.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/25/2018] [Accepted: 04/30/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Rising trend in Non-Communicable Diseases (NCDs) in developing countries often result in sudden death, which are largely preventable through effective cardiopulmonary resuscitation (CPR). Most communities in Sub-Saharan Africa, however, lack access to CPR services, due to a deficiency in requirements for the establishment of such services. These requirements can be grouped into a triad of awareness, infrastructure and capacity building. AIM This study was aimed at assessing the perceived need and recommendations for improvement in CPR services in Cross River State. METHODS Proportionate sampling was used to recruit healthcare workers in this cross-sectional study. Data was obtained using semi-structured open-ended questionnaire consisting of recommendations for improving CPR services. Responses were coded and grouped into three essential areas. Data were entered and analysed using SPSS version 20.0. RESULT Two hundred and twenty-nine (229) questionnaires were completed; mean age of respondents was 42.1 ± 11.2 years. The commonest cadre of healthcare worker was nurses (135, 59.0%). One, two, and three areas of suggestions were made by 55.5%, 37.1%, and 7.4% of respondents, respectively. Suggestions included training of health care workers on CPR (111, 48.5%) and provision of resuscitation equipment (95, 41.5%). Sixty-five respondents (29.3%) recommended creating awareness and means of contact, while some respondents recommended capacity building (132, 57.6%) and resuscitation infrastructure set-up (149, 65.1%). CONCLUSION Healthcare workers perceive an urgent need for the establishment of CPR services in our health facilities and communities. There is need to address the triad of awareness, infrastructure and capacity building for the establishment of CPR services peculiar to Sub-Saharan Africa.
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Affiliation(s)
| | - Oboko Oboko Oku
- Department of Anaesthesiology, University of Calabar, Calabar, Nigeria
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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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Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study. Pediatr Crit Care Med 2017; 18:120-127. [PMID: 28165347 DOI: 10.1097/pcc.0000000000000977] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. DESIGN Randomized controlled study. SETTING Children's hospital at a tertiary care academic medical center. SUBJECTS Forty-two first-year pediatric residents. INTERVENTIONS Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin. During the second evaluation, the residents in the Google Glass group were allowed to seek help from a remote intensivist at any time by activating real-time video communication. The residents in the control group were asked to provide usual care. MEASUREMENTS AND MAIN RESULTS The main outcome measures were the proportion of time for which the manikin received no ventilation (no-blow fraction) or no compression (no-flow fraction). In the first evaluation, overall no-blow and no-flow fractions were 74% and 95%, respectively. During the second evaluation, no-blow and no-flow fractions were similar between the two groups. Insufflations were more effective (p = 0.04), and the technique (p = 0.02) and rate (p < 0.001) of chest compression were more appropriate in the Google Glass group than in the control group. CONCLUSIONS Real-time video communication between the first responder and a remote intensivist through Google Glass did not decrease no-blow and no-flow fractions during the first 5 minutes of a simulated pediatric cardiopulmonary arrest but improved the quality of the insufflations and chest compressions provided.
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Interactive videoconferencing versus audio telephone calls for dispatcher-assisted cardiopulmonary resuscitation using the ALERT algorithm: a randomized trial. Eur J Emerg Med 2016; 23:418-424. [DOI: 10.1097/mej.0000000000000338] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Melbye S, Hotvedt M, Bolle SR. Mobile videoconferencing for enhanced emergency medical communication - a shot in the dark or a walk in the park? ‒‒ A simulation study. Scand J Trauma Resusc Emerg Med 2014; 22:35. [PMID: 24887256 PMCID: PMC4055691 DOI: 10.1186/1757-7241-22-35] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/20/2014] [Indexed: 01/27/2023] Open
Abstract
Background Videoconferencing on mobile phones may enhance communication, but knowledge on its quality in various situations is needed before it can be used in medical emergencies. Mobile phones automatically activate loudspeaker functionality during videoconferencing, making calls particularly vulnerable to background noise. The aim of this study was to investigate if videoconferencing can be used between lay bystanders and Emergency Medical Dispatch (EMD) operators for initial emergency calls during medical emergencies, under suboptimal sound and light conditions. Methods Videoconferencing was tested between 90 volunteers and an emergency medical dispatcher in a standardized scenario of a medical emergency. Three different environments were used for the trials: indoors with moderate background noise, outdoors with daylight and much background noise, and outdoors during nighttime with little background noise. Thirty participants were recruited for each of the three locations. After informed consent, each participant was asked to use a video mobile phone to communicate with an EMD operator. During the video call the EMD operator gave instructions for tasks to be performed by the participant. The video quality from the caller to the EMD was evaluated by the EMD operator and rated on a five step scale ranging from "not able to see" to "good video quality". Sound quality between participants and EMD operators was assessed by a method developed for this trial. Kruskal – Wallis and Chi-square tests were used for statistical analysis. Results Video quality was significantly different between the groups (p <0.001), and the nighttime group had lower video quality. For most sessions in the nighttime group it was still possible to see actions done at the simulated emergency site. All participants were able to perform their tasks according to the instructions given by dispatchers, although with a need for more repetitions during sessions with much background noise. No calls were rated by dispatchers as incomprehensible due to low sound quality and only 3% of the calls were considered somewhat difficult or very difficult to understand. Conclusions Videoconferencing on mobile phones can be used for the initial emergency call during medical emergencies also in suboptimal conditions.
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Affiliation(s)
- Sigurd Melbye
- Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
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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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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: 1042] [Impact Index Per Article: 94.7] [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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Paal P, Pircher I, Baur T, Gruber E, Strasak AM, Herff H, Brugger H, Wenzel V, Mitterlechner T. Mobile phone-assisted basic life support augmented with a metronome. J Emerg Med 2012; 43:472-7. [PMID: 22257600 DOI: 10.1016/j.jemermed.2011.09.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 04/26/2011] [Accepted: 09/27/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Basic life support (BLS) performed by lay rescuers is poor. We developed software for mobile phones augmented with a metronome to improve BLS. STUDY OBJECTIVES To assess BLS in lay rescuers with or without software assistance. METHODS Medically untrained volunteers were randomized to run through a cardiac arrest scenario with ("assisted BLS") or without ("non-assisted BLS") the aid of a BLS software program installed on a mobile phone. RESULTS Sixty-four lay rescuers were enrolled in the "assisted BLS" and 77 in the "non-assisted BLS" group. The "assisted BLS" when compared to the "non-assisted BLS" group, achieved a higher overall score (19.2 ± 7.5 vs. 12.9 ± 5.7 credits; p < 0.001). Moreover, the "assisted BLS" when compared to the "non-assisted" group checked (64% vs. 27%) and protected themselves more often from environmental risks (70% vs. 39%); this group also called more often for help (56% vs. 27%), opened the upper airway (78% vs. 16%), and had more correct chest compressions rates (44% ± 38% vs. 14% ± 28%; all p < 0.001). However, the "assisted BLS" when compared to the "non-assisted BLS" group, was slower in calling the dispatch center (113.6 ± 86.4 vs. 54.1 ± 45.1 s; p < 0.001) and starting chest compressions (165.3 ± 93.3 vs. 87.1 ± 53.2 s; p < 0.001). CONCLUSIONS "Assisted BLS" augmented by a metronome resulted in a higher overall score and a better chest compression rate when compared to "non-assisted BLS." However, in the "assisted BLS" group, time to call the dispatch center and to start chest compressions was longer. In both groups, lay persons did not ventilate satisfactorily during this cardiac arrest scenario.
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Affiliation(s)
- Peter Paal
- Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
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Video analysis of dispatcher-rescuer teamwork-Effects on CPR technique and performance. Resuscitation 2011; 83:494-9. [PMID: 21982923 DOI: 10.1016/j.resuscitation.2011.09.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/29/2011] [Accepted: 09/22/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We wanted to study the effect of continuous dispatcher communication on CPR technique and performance during 10min of simulated cardiac arrest. METHOD We reviewed video recordings and manikin data from 30 CPR trained lay people who where left alone in a simulated cardiac arrest situation with a manikin in a home-like environment (in a small, confined kitchen with the disturbing noise of a radio). CPR was performed for 10min with continuous telephone instructions via speaker function from a dispatcher. The dispatcher was blinded for CPR performance and video. Dispatcher communication, compression technique and ventilation technique was scored as accomplished or failed in the 1st and 10th minute. RESULTS 29/30 rescuers were able to hear instructions, answer questions from the dispatcher and perform CPR in parallel. Rescuer position beside manikin was initially correct for 13/30, improving to 21/30 (p=0.008). Compression technique was adequate for the whole episode, with an insignificant trend for improvement; 29 to 30/30 using straight arms, 28 to 30/30 in a vertical position over chest and 24 to 27/30 counting loudly. 17/29 placed their hands between the nipples initially, improving to 24/29 (p=0.065). Mean compression rate improved from 84 to 101min(-1) (p<0.001), and compression depth maintained adequate (43 to 42mm). Initially, 17/29 used chin-lift manoeuvre, 14/30 used head-tilt and 19/29 used nose pinch to manage open airways, compared to 18, 20 and 22/29 (ns) in the 10th minute, respectively. Successful delivery of ventilation improved from 13/30 to 23/30 (p=0.006). CONCLUSION Bystander and dispatcher can communicate successfully during ongoing CPR using a telephone with speaker function. CPR technique and quality improved or did not change over 10min with continuous dispatcher assistance. These results suggest a potential for improved bystander CPR using rescuer-dispatcher teamwork.
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Bolle SR, Hasvold P, Henriksen E. Video calls from lay bystanders to dispatch centers - risk assessment of information security. BMC Health Serv Res 2011; 11:244. [PMID: 21958387 PMCID: PMC3198924 DOI: 10.1186/1472-6963-11-244] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 09/30/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Video calls from mobile phones can improve communication during medical emergencies. Lay bystanders can be instructed and supervised by health professionals at Emergency Medical Communication Centers. Before implementation of video mobile calls in emergencies, issues of information security should be addressed. METHODS Information security was assessed for risk, based on the information security standard ISO/IEC 27005:2008. A multi-professional team used structured brainstorming to find threats to the information security aspects confidentiality, quality, integrity, and availability. RESULTS Twenty security threats of different risk levels were identified and analyzed. Solutions were proposed to reduce the risk level. CONCLUSIONS Given proper implementation, we found no risks to information security that would advocate against the use of video calls between lay bystanders and Emergency Medical Communication Centers. The identified threats should be used as input to formal requirements when planning and implementing video calls from mobile phones for these call centers.
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Affiliation(s)
- Stein R Bolle
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway
- Division of Trauma Care and Pre-Hospital Services, University Hospital of North Norway, N-9038 Tromsø, Norway
| | - Per Hasvold
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway
| | - Eva Henriksen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, N-9038 Tromsø, Norway
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Neumar RW, Barnhart JM, Berg RA, Chan PS, Geocadin RG, Luepker RV, Newby LK, Sayre MR, Nichol G. Implementation strategies for improving survival after out-of-hospital cardiac arrest in the United States: consensus recommendations from the 2009 American Heart Association Cardiac Arrest Survival Summit. Circulation 2011; 123:2898-910. [PMID: 21576656 DOI: 10.1161/cir.0b013e31821d79f3] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Drager KK. Improving patient outcomes with compression-only CPR: will bystander CPR rates improve? J Emerg Nurs 2011; 38:234-8. [PMID: 21514650 DOI: 10.1016/j.jen.2011.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 02/01/2011] [Accepted: 02/02/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Kristin K Drager
- Emergency Department, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
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Bolle SR, Johnsen E, Gilbert M. Video calls for dispatcher-assisted cardiopulmonary resuscitation can improve the confidence of lay rescuers – surveys after simulated cardiac arrest. J Telemed Telecare 2010; 17:88-92. [DOI: 10.1258/jtt.2010.100605] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many mobile phones allow two-way video communication, which permits callers to hear and see each other. If used during medical emergencies, bystanders can receive supervision and guidance from medical staff based on visual information. We investigated whether video calls from mobile phones could improve the confidence of lay rescuers. High school students ( n = 180) were randomly assigned in groups of three to communicate via video calls or via ordinary mobile phone calls. They received realtime guidance from experienced nurse dispatchers at an emergency medical dispatch centre during 10-min scenarios of simulated cardiac arrest. Each student answered a questionnaire to assess understanding, confidence and usefulness of the technology. The mean age was 17.3 years in the video group and 17.9 years in the audio group. There were 27% male participants in the video group and 34% male participants in the audio group. Seventy-three percent of the students in the video group and 71% in the audio group reported previous cardiopulmonary resuscitation training. Rescuers who had not used video phones had a greater tendency to comment on immature video call technology, while some who had used video phones complained about poor sound quality during video calls. The majority of rescuers in both groups believed that video calls were superior to audio calls during medical emergencies, and this proportion was significantly higher in the video group ( P = 0.0002). We found that visual contact and supervision through video calls improved rescuers' confidence in stressful emergencies.
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Affiliation(s)
- Stein R Bolle
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
- Division of Trauma Care and Pre-Hospital Services, University Hospital of North Norway, Tromsø, Norway
| | - Elin Johnsen
- Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway
| | - Mads Gilbert
- Division of Trauma Care and Pre-Hospital Services, University Hospital of North Norway, Tromsø, Norway
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Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2010; 122:S539-81. [PMID: 20956260 DOI: 10.1161/circulationaha.110.971143] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
OBJECTIVES This paper describes the set-up of a videoconference system to support resuscitation in remote communities and the outcome of the video support. STUDY DESIGN A case study examining the use of videoconferencing to lead life support remotely. METHODS Resuscitations in these communities were led remotely by a physician through videoconferencing. The videoconference unit is set up in the corner of the room for optimal viewing of the patient and the monitors. The keys to success are a secure 512 kbps broadband service, user-friendly videoconference units and appropriate training. RESULTS Over the past 3 years in Labrador, 6 patients with major trauma, pulseless tachyarrhythmias, cardiogenic shock, septic shock and severe hypothermia were successfully resuscitated. CONCLUSION Oversight of life support via videoconferencing with the right set-up and training can lead to successful resuscitation in remote communities.
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Affiliation(s)
- Michael Jong
- Memorial University, Labrador Health Centre, Goose Bay, Newfoundland, Canada.
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Soar J, Mancini ME, Bhanji F, Billi JE, Dennett J, Finn J, Ma MHM, Perkins GD, Rodgers DL, Hazinski MF, Jacobs I, Morley PT. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81 Suppl 1:e288-330. [PMID: 20956038 PMCID: PMC7184565 DOI: 10.1016/j.resuscitation.2010.08.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol,United Kingdom.
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