Robust real-time chest compression rate detection from smartphone video

Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested.

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Pulse rate as an alternative, real-time feedback indicator for chest compression rate: a porcine model of cardiac arrest

Journal of Clinical Monitoring and Computing ◽

10.1007/s10877-020-00576-x ◽

2020 ◽

Author(s):

Yangyang Fu ◽

Lu Yin ◽

Samuel Seery ◽

Jiayuan Dai ◽

Huadong Zhu ◽

...

Keyword(s):

Cardiac Arrest ◽

Real Time ◽

Chest Compression ◽

Pulse Rate ◽

Porcine Model ◽

Compression Rate

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Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158087 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8087

Author(s):

Dongjun Yang ◽

Wongyu Lee ◽

Jehyeok Oh

Keyword(s):

Cardiopulmonary Resuscitation ◽

Chest Compression ◽

Healthcare Providers ◽

Compression Rate ◽

Audio Feedback ◽

Simple Method ◽

Compression Depth ◽

Pediatric Resuscitation ◽

Cpr Quality

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.

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Abstract 343: Chest Compression Compliance With Guidelines Declines Over the Course of Rescues

Circulation ◽

10.1161/circ.140.suppl_2.343 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Author(s):

James K Russell ◽

Digna González Otero ◽

Sofia Ruiz de Gauna ◽

Mikel Leturiondo ◽

Jesus M Ruiz ◽

...

Keyword(s):

Real Time ◽

Chest Compression ◽

Steady Increase ◽

Release Force

Introduction: CPR guidelines recommend limits for rate and depth, and release (avoidance of leaning). Simultaneous compliance with all three recommendations is challenging, sustained compliance more so. Hypothesis: Compliance with rate, depth and release guidelines is limited, and will decline over the course of rescues. Methods: Acceleration and force signals were extracted from monitor/defibrillators equipped with CPR monitors in 248 adult cases of manual CPR during out-of-hospital resuscitations treated by Tualatin Valley Fire & Rescue (TVF&R, Tigard, OR) during 2016 and 2017. TVF&R personnel delivered continuous compression CPR with real-time feedback available for rate, depth and leaning. Depth was calculated from acceleration. Peak depth, release force, and rate were measured for each compression. Release with force exceeding 2.5 kg-f was counted as incomplete (leaning). Results: Cases included 1802 (1055-2683) (median, IQR) compressions (total 481,407 compressions). Compliance with all three recommendations was 25% initially, declining to 19% for the ends of the longest rescues (> 3000 compressions from 48 cases). Depth compliance and complete release varied relatively little (31-36%, 93-95% respectively) and irregularly over the course of resuscitation. Early, 45% of compressions were too shallow (< 50 mm), and 21% were too deep (> 60 mm). Depth exceptions shifted over the course of resuscitation (to 36%, 28% respectively). Rate compliance declined from 73% to 54%. Rates below 100 cpm were 9% initially, declining to 5%. Rates exceeding 120 cpm were 18% early on, but climbed to 41% towards the end of long resuscitations, accounting for most of the decline in compliance with guidelines. Conclusions: Compliance with all 3 recommendations for CPR compressions is challenging, and becomes more so as the chest changes in response to compressions. Most problematic is a steady increase in compression rates above 120 cpm.

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Leg-heel chest compression as an alternative for medical professionals in times of COVID-19

10.1101/2021.03.09.21253220 ◽

2021 ◽

Author(s):

Matthias Ott ◽

Alexander Krohn ◽

Laurence H. Bilfield ◽

F. Dengler ◽

C. Jaki ◽

...

Keyword(s):

Chest Compression ◽

Effective Alternative ◽

Medical Professionals ◽

Compression Rate ◽

Compression Depth ◽

Significant Difference ◽

Manual Chest Compression ◽

Special Circumstances ◽

Previous Training

AbstractObjectiveTo evaluate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression.Methods20 medical professionals performed standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. We compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods. In a second approach, potential aerosol spread during chest compression was visualized.ResultsThere was no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method.ConclusionUnder special circumstances like COVID-19-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient.

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Abstract 133: Electrical Insulating Gloves for Safe Hands-on Defibrillation Do Not Compromise the Quality of Chest Compressions

Circulation ◽

10.1161/circ.130.suppl_2.133 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Jakob E Thomsen ◽

Martin Harpsø ◽

Graham W Petley ◽

Svend Vittinghus ◽

Charles D Deakin ◽

...

Keyword(s):

Clinical Examination ◽

Chest Compression ◽

Electrical Insulation ◽

Compression Rate ◽

Chest Compressions ◽

Compression Depth ◽

Resuscitation Guidelines ◽

Hands On ◽

Class 1

Introduction: We have recently shown that Class 1 electrical insulating gloves are safe for hands-on defibrillation. Continuous chest compressions during defibrillation reduce the peri-shock pauses and increase the subsequent chance of successful defibrillation. In this study we have investigated the effect of these electrical insulation gloves on the quality of chest compressions, compared with normal clinical examination gloves. Methods: Emergency medical technicians trained in 2010 resuscitation guidelines delivered uninterrupted chest compressions for 6 min on a manikin, whilst wearing Class 1 electrical insulating gloves or clinical examination gloves. The order of gloves was randomized and each session of chest compressions was separated by at least 30 min to avoid fatigue. Data were collected from the manikin. Compression depth and compression rate were compared. Results: Data from 35 participants are shown in Figure 1. There was no statistically significant difference between Class 1 electrical insulating gloves in chest compression depth (median±range: 45 (28-61) vs 43 (28-61) p=0.69) and chest compression rate (113 (67-150) vs 113(72-145), p=0.87) when compared to clinical examination cloves. Conclusion: These preliminary data suggest that the use of Class 1 electrical insulation gloves does not reduce the quality of chest compressions during simulated CPR compared to clinical examination gloves.

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Abstract 2019: Untrained Volunteers Perform High Quality CPR When using an Automatic External Defibrillator with a CPR Voice Prompting Algorithm

Circulation ◽

10.1161/circ.116.suppl_16.ii_437 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Benjamin S Abella ◽

Salem Kim ◽

Alexandra Colombus ◽

Cheryl L Shea ◽

Lance B Becker

Keyword(s):

Real Time ◽

Patient Outcomes ◽

Chest Compression ◽

Automatic External Defibrillator ◽

Chest Compressions ◽

High Quality ◽

Cpr Training ◽

Adult Volunteers ◽

Improve Patient ◽

External Defibrillator

Background: Recent investigations have demonstrated that CPR performance among trained providers can be improved by audiovisual prompting and real-time feedback, and higher quality CPR before defibrillation can improve shock success and has the potential to improve patient outcomes. Objective: We hypothesized that simplified voice prompts incorporated into an automatic external defibrillator (AED) can lead to improvements in CPR performance by untrained lay rescuers. Methods: Adult volunteers with no prior CPR training were assessed in their use of an AED with chest compression voice instructions and metronome prompts on a CPR-recording manikin. Volunteers were given minimal instructions regarding use of the device and were given no instructions regarding CPR performance. The AED was designed to prompt five cycles of 30 chest compressions between defibrillatory attempts. Chest compression rates and depths were measured via review of videotape and manikin recording data, respectively. Results: A total of 60 adults were assessed in their use of the AED, with a mean age of 33.6±12.8; 36/63 (57%) were female. Mean chest compression rate was 103±12 and mean depth was 37±14 mm. Furthermore, minimal decay in chest compression rates occurred over 5 cycles of chest compressions, with mean rate of 101±19 during the first cycle and 104±10 during the 5 th cycle. No volunteers were unable to use the AED or complete 5 cycles of chest compressions. Conclusions: Our work demonstrates that with appropriate real-time prompts delivered even in the absence of training or human coaching, laypersons can perform CPR that has a quality often similar to trained providers. This finding has important implications for AED design especially in light of the renewed importance of both CPR and the interaction of quality chest compressions and defibrillatory success.

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