The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching.

OBJECTIVE Bystander cardiopulmonary resuscitation (CPR) has shown to significantly improve the survival of cardiac-arrest victims. Dispatcher assistance increases the number of bystanders who perform CPR, but the quality of CPR remains unsatisfactory. This study was conducted to assess the effect of video coaching on the performance of CPR by untrained volunteers when compared with traditional audio instruction in simulated cardiac arrests. METHODS Adult volunteers were randomised to receive audio-assisted instructions (audio group=39), or video-demonstrated instructions (video group=39) via cellular phones on how to perform chest compressions on mannequins. Then, the volunteers' performances were video-recorded. The quality of CPR was evaluated by reviewing the videos and mannequin reports. RESULTS For the video group, the chest compression rate was more optimal (99.5min(-1) vs. 77.4min(-1), P<0.01) and the time from the initial phone call to the first compressions was shorter (184s vs. 211s, P<0.01). The depth of compressions was deeper in the audio group (31.3mm vs. 27.5mm, P=0.21), but neither group performed the recommended depth of compression. The hand positions for compression were more appropriate in the video group (71.8% vs. 43.6%, P=0.01). As many as 71.8% of the video group had no 'hands-off' events when performing compression (vs. 46.2% for the audio group, P=0.02). CONCLUSIONS Instructions from the dispatcher, along with a video demonstration of CPR, improved the time to initiate compression, the compression rate and the correct hand positioning. It also reduced the 'hands-off' events during CPR. However, emphasised instructions by video may be needed to increase the depth of compressions.

[1]  Roger D. White,et al.  Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. , 2008, Circulation.

[2]  D J Roe,et al.  Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. , 1997, Circulation.

[3]  S. Yoo,et al.  The effectiveness of cardiopulmonary resuscitation instruction: animation versus dispatcher through a cellular phone. , 2008, Resuscitation.

[4]  D. Oh,et al.  Current Status of CPR in Korea , 2007 .

[5]  J. You,et al.  Mobile phone CPR: the national campaign in South Korea. , 2008, Resuscitation.

[6]  Cpr , 2005, Key Topics In Anaesthesia.

[7]  Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. , 2002 .

[8]  J. Clawson.  A simulation trial of traditional dispatcher-assisted CPR versus compressions--only dispatcher-assisted CPR. , 2007, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[9]  B. Abella,et al.  Uniform reporting of measured quality of cardiopulmonary resuscitation (CPR). , 2007, Resuscitation.

[10]  Z. Yen,et al.  Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests* , 2009, Critical care medicine.

[11]  T. Fukui,et al.  Estimating the effect of bystander-initiated cardiopulmonary resuscitation in Japan. , 2001, Resuscitation.

[12]  P. Steen,et al.  Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly. , 2003, Resuscitation.

[13]  B D PETROV,et al.  In Japan … , 1975, Sovetskoe zdravookhranenie.

[14]  Judith A. Long,et al.  Cell phone cardiopulmonary resuscitation: audio instructions when needed by lay rescuers: a randomized, controlled trial. , 2010, Annals of emergency medicine.