Abstract 240: Smartphone Application to Provide Real-Time Cardiopulmonary Resuscitation Quality Feedback

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Emily Stumpf ◽  
Ravi Ambati ◽  
Raj Shekhar ◽  
Steven Staffa ◽  
David Zurakowski ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Mobile Application ◽  
Sensor Data ◽  
Smart Device ◽  
Compression Rate ◽  
Acceleration Sensor ◽  
Compression Depth ◽  
Quality Feedback ◽  
Cpr Quality

Introduction: Quality of cardiopulmonary resuscitation (CPR) contributes significantly to morbidity and mortality in both in-hospital and out-of-hospital cardiac arrest. Key parameters that determine the CPR quality are compression rate, compression depth, duration of interruptions, chest recoil factor and respiratory rate. Several studies have demonstrated that real-time audiovisual feedback improves CPR quality in both bystanders and hospital staff. This study aims to develop and validate a smart device (phones and wearable technology) application to provide real-time audiovisual and haptic feedback to optimize CPR quality, by calculating aforementioned chest compression parameters. Hypothesis: A mobile application using acceleration sensor data from smart devices can provide accurate real time CPR quality feedback. Methods: A mobile application was developed to track the compression depth, compression rate and pause duration in real time using the data captured from the on-device accelerometer. The mobile device was placed on an adult manikin’s chest along the midline close to the point of compressions. Data from the application was compared directly to data obtained from a validated clinical standard CPR quality tool. Results: CPR quality parameters were obtained from the app and the standard for 60, 10-second-long sessions. Bland-Altman plot analysis for compression depth showed agreement between the app measurements and standard within +/-3.5mm (Figure 1). The intraclass correlation for agreement in the measurement of compression count was 0.92 (95% CI: 0.88-0.95), indicative of very strong agreement. Conclusions: Smart device (phones and wearable technology) applications using acceleration sensor data can accurately provide real-time CPR quality feedback. With further development and validation they can provide a ubiquitous CPR feedback tool valuable for out of hospital arrests and in under-privileged areas worldwide.

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

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.

scholarly journals Metronome Use Positively Affect Cardiopulmonary Resuscitation Parameters: Prospective Observational Multicenter Manikin Study

2020 ◽  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Minute Ventilation ◽  
Heart Association ◽  
High Volume ◽  
Compression Rate ◽  
Compression Depth ◽  
Manikin Study ◽  
Volume Ventilation ◽  
Cpr Quality

Objective: Clinical studies have shown that eliminating performer errors is important to ensure high quality cardiopulmonary resuscitation (CPR). Literature on the effects of metronome use on the quality of CPR is scarce. This study aimed to investigate the effect of metronome use on the quality of cardiopulmonary resuscitation. Methods: Thirty volunteer emergency physicians who were divided into 15 groups participated in this prospective, observational, multi-center, manikin study. Firstly, each participant performed conventional CPR on a manikin, and then performed metronome-guided CPR after a short break. Parameters affecting CPR quality were evaluated based on the recommendations of the 2015 American Heart Association CPR and Emergency Cardiovascular Care Guideline. In addition, the fatigue levels of participants were evaluated using the Borg Fatigue Index. Results: Metronome-guided CPR significantly improved the chest compression rate (median (Interquartile Range-IQR); 128 (22) compressions/min vs. 110 (2) compressions/min; 95%CI, p < 0.001), deep compression rate (median (IQR); 95.25 (80) compressions/min vs. 72.63 (105) compressions/min; 95%CI, p < 0.001), compression depth (median (IQR); 62.50 (11) mm vs. 60.25 (14) mm; 95%CI, p = 0.016), ventilation number (median (IQR); 11.25 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.001), high-volume ventilation count (median (IQR); 10.13 (6) ventilations/min vs. 9.50 (1) ventilations/min; 95%CI, p = 0.026), minute ventilation volume (median (IQR); 11.75 (10) L/min vs. 8.03 (3) L/min; 95%CI, p < 0.05), and fatigue levels (median (IQR); 3 (2) vs. 2 (2); in 95%CI, p < 0.05). Conclusions: Our study showed that metronome is a useful device for reaching effective CPR. Metronome guidance may change the CPR parameters positively. This study is in accordance with previous studies which have investigated the effect of metronome-guided CPR on survival.

scholarly journals The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 80-88 ◽  
Author(s):  
Adam Cheng ◽  
Yiqun Lin ◽  
Vinay Nadkarni ◽  
Brandi Wan ◽  
Jonathan Duff ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Visual Feedback ◽  
Just In Time ◽  
Average Height ◽  
Compression Depth ◽  
Simulation Based ◽  
Cpr Quality ◽  
Cpr Training ◽  
Gender Specific

AbstractObjectivesWe aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality.MethodsWe analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use.ResultsOne hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth.ConclusionsStep stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

Cost-effectiveness analysis of workplace-based distributed cardiopulmonary resuscitation training versus conventional annual basic life support training

2020 ◽  
pp. bmjstel-2020-000709
Author(s):  
Yiqun Lin ◽  
Kent Hecker ◽  
Adam Cheng ◽  
Vincent J Grant ◽  
Gillian Currie
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cardiopulmonary Resuscitation ◽  
Real Time ◽  
Care Providers ◽  
Training Time ◽  
Distributed Training ◽  
Cpr Quality ◽  
The Cost ◽  
Cpr Training

ContextAlthough distributed cardiopulmonary resuscitation (CPR) practice has been shown to improve learning outcomes, little is known about the cost-effectiveness of this training strategy. This study assesses the cost-effectiveness of workplace-based distributed CPR practice with real-time feedback when compared with conventional annual CPR training.MethodsWe measured educational resource use, costs, and outcomes of both conventional training and distributed training groups in a prospective-randomised trial conducted with paediatric acute care providers over 12 months. Costs were calculated and reported from the perspective of the health institution. Incremental costs and effectiveness of distributed CPR training relative to conventional training were presented. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) if appropriate. One-way sensitivity analyses and probabilistic sensitivity analysis were conducted.ResultsA total of 87 of 101 enrolled participants completed the training (46/53 in intervention and 41/48 in the control). Compared with conventional training, the distributed CPR training group had a higher proportion of participants achieving CPR excellence, defined as over 90% guideline compliant for chest compression depth, rate and recoil (control: 0.146 (6/41) vs intervention 0.543 (25/46), incremental effectiveness: +0.397) with decreased costs (control: $C266.50 vs intervention $C224.88 per trainee, incremental costs: −$C41.62). The sensitivity analysis showed that when the institution does not pay for the training time, distributed CPR training results in an ICER of $C147.05 per extra excellent CPR provider.ConclusionWorkplace-based distributed CPR training with real-time feedback resulted in improved CPR quality by paediatric healthcare providers and decreased training costs, when training time is paid by the institution. If the institution does not pay for training time, implementing distributed training resulted in better CPR quality and increased costs, compared with conventional training. These findings contribute further evidence to the decision-making processes as to whether institutions/programmes should financially adopt these training programmes.

scholarly journals Effect of introducing a feedback device during adult and infant cardiopulmonary resuscitation training: A ‘before and after’ study

2018 ◽  
Vol 27 (2) ◽  
pp. 114-117
Author(s):  
Kwan Ho Kim ◽  
Chan Woong Kim ◽  
Je Hyeok Oh
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Compression Rate ◽  
Practice Session ◽  
Compression Depth ◽  
Training Course ◽  
Resuscitation Training ◽  
Before And After ◽  
Practice Time ◽  
Positive Effect ◽  
Before And After Study

Objective: This study aimed to verify the effect of introducing a feedback device during adult and infant cardiopulmonary resuscitation training. Methods: A feedback device was introduced in the cardiopulmonary resuscitation training course of our medical school in the middle of the last semester. The cardiopulmonary resuscitation training course consisted of 2 h of instructor-led cardiopulmonary resuscitation training and 1 h of self-practice time. All students should complete the adult and infant cardiopulmonary resuscitation skill tests just after the course. Each test consisted of five cycles of single-rescuer cardiopulmonary resuscitation. A feedback device was introduced only in the self-practice session. The cardiopulmonary resuscitation parameters of the skill tests before ( n = 40) and after ( n = 39) introducing the feedback device were analysed. Results: The ratios of correct rate significantly increased after introducing the feedback device in both the skill tests (adult test: 58.5 ± 37.2 vs 85.5 ± 21.4, p = 0.001; infant test: 55.0 ± 32.4 vs 80.2 ± 20.7, p = 0.001). Although the average depths did not significantly differ between those before and after introducing the feedback device in the adult test (58.4 ± 4.0 mm vs 59.0 ± 3.7 mm, p = 0.341), it increased significantly after introducing the feedback device in the infant test (38.3 ± 4.3 mm vs 40.8 ± 1.1 mm, p = 0.001). Conclusion: Introducing a feedback device might have enhanced the accuracies of compression rate in adult and infant cardiopulmonary resuscitation training. However, the potential positive effect on chest compression depth was limited to infant cardiopulmonary resuscitation training.

scholarly journals Real-Time Chest Compression Quality Measurements by Smartphone Camera

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Øyvind Meinich-Bache ◽  
Kjersti Engan ◽  
Tonje Søraas Birkenes ◽  
Helge Myklebust
Keyword(s):  
Cardiac Arrest ◽  
Real Time ◽  
Chest Compression ◽  
Quality Measurement ◽  
Smartphone Application ◽  
Average Error ◽  
Compression Rate ◽  
Chest Compressions ◽  
Compression Time ◽  
Cpr Quality

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.

scholarly journals Classification of cow’s behaviors based on 3-DoF accelerations from cow’s movements

2019 ◽  
Vol 9 (3) ◽  
pp. 1656
Author(s):  
Phung Cong Phi Khanh ◽  
Kieu Thi Nguyen ◽  
Nguyen Dinh-Chinh ◽  
Tran Duc-Nghia ◽  
Hoang Quang Trung ◽  
...  
Keyword(s):  
Decision Tree ◽  
Data Acquisition ◽  
Real Time ◽  
Wireless Transmission ◽  
Sensor Data ◽  
Test Results ◽  
Acceleration Sensor

Cow’s behavior classification helps people to monitor cow activities, thus the health and physiological periods of cows can be well tracked. To classify the behavior of cows, the data from the 3-axis acceleration sensor mounted on their neck is often used. Data acquisition and preprocessing of sensor data is required in this device. We acquire data from the 3-axis acceleration sensor mounted on the cows’neck and send to the microcontrollter. At the microcontroller, a proposed decision tree is applied in real-time manner to classify four important activities of the cows (standing, lying, feeding, and walking). Finally, the results can be sent to the server through the wireless transmission module. The test results confirm the reliability of the proposed device.

Automated Audiovisual Feedback in Cardiopulmonary Resuscitation Training: Improving Skills in Pediatric Intensive Care Nurses

2018 ◽  
Vol 38 (5) ◽  
pp. 59-66
Author(s):  
Robert Bishop ◽  
Brian Joy ◽  
Melissa Moore-Clingenpeel ◽  
Tensing Maa
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Health Care Professionals ◽  
Life Support ◽  
Target Range ◽  
Compression Rate ◽  
Improvement Program ◽  
High Quality ◽  
Median Percentage ◽  
Compression Depth ◽  
Resuscitation Training

Background High-quality cardiopulmonary resuscitation is associated with improved survival and neurological outcomes after cardiac arrest. Unfortunately, health care professionals frequently do not perform resuscitation within guidelines after life-support training. Objectives To determine if brief intermittent training in cardiopulmonary resuscitation could improve nurses’ skills to perform high-quality resuscitation 70% or more of the time during 2 minutes of cardiopulmonary resuscitation after 3 training sessions. Methods In a prospective single-center quality improvement program, pediatric critical care nurses had monthly training in cardiopulmonary resuscitation. A portable manikin/defibrillator with a chest compression sensor was used to provide corrective audiovisual feedback to optimize resuscitation skills. Resuscitation was practiced on an adult manikin. Target goals were compression depth 2 in or greater at a compression rate of 100/min to 120/minute. Percentage of time in the target range and mean compression depth and rate were recorded. Data were collected every other month. The percentage of time both compression rate and depth were in the target range was compared among nurses with different total numbers of training sessions. Results Of the 62 nurses who participated in the training, 48 had data collected. The median percentage of time in the target range improved from 29% with no training to 46% after 1 session, 54% after 2 sessions, 68% after 3 sessions, and 74% after 4 sessions (P = .001). Compression depth increased with the number of training sessions (P = .002). Conclusions This training program in cardiopulmonary resuscitation yielded significant skill improvement and retention.

scholarly journals A Feasibility Study for Measuring Accurate Chest Compression Depth and Rate on Soft Surfaces Using Two Accelerometers and Spectral Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Sofía Ruiz de Gauna ◽  
Digna M. González-Otero ◽  
Jesus Ruiz ◽  
J. J. Gutiérrez ◽  
James K. Russell
Keyword(s):  
Spectral Analysis ◽  
Cardiopulmonary Resuscitation ◽  
Feasibility Study ◽  
Chest Compression ◽  
Compression Rate ◽  
Compression Depth ◽  
Test Conditions ◽  
Median Error

Background. Cardiopulmonary resuscitation (CPR) feedback devices are being increasingly used. However, current accelerometer-based devices overestimate chest displacement when CPR is performed on soft surfaces, which may lead to insufficient compression depth. Aim. To assess the performance of a new algorithm for measuring compression depth and rate based on two accelerometers in a simulated resuscitation scenario. Materials and Methods. Compressions were provided to a manikin on two mattresses, foam and sprung, with and without a backboard. One accelerometer was placed on the chest and the second at the manikin’s back. Chest displacement and mattress displacement were calculated from the spectral analysis of the corresponding acceleration every 2 seconds and subtracted to compute the actual sternal-spinal displacement. Compression rate was obtained from the chest acceleration. Results. Median unsigned error in depth was 2.1 mm (4.4%). Error was 2.4 mm in the foam and 1.7 mm in the sprung mattress (p<0.001). Error was 3.1/2.0 mm and 1.8/1.6 mm with/without backboard for foam and sprung, respectively (p<0.001). Median error in rate was 0.9 cpm (1.0%), with no significant differences between test conditions. Conclusion. The system provided accurate feedback on chest compression depth and rate on soft surfaces. Our solution compensated mattress displacement, avoiding overestimation of compression depth when CPR is performed on soft surfaces.

Abstract 1806: End-tidal Carbon Dioxide as a Measure of Cardiopulmonary Resuscitation Efficacy during Human Cardiac Arrest

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Joshua L Wallbrecht ◽  
Dana P Edelson ◽  
Barbara Litzinger ◽  
Deborah Walsh ◽  
Terry L Vanden Hoek ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Arrest ◽  
Chest Compression ◽  
Compression Rate ◽  
Medical Systems ◽  
Compression Depth ◽  
Mean Values ◽  
End Tidal Carbon Dioxide ◽  
Cpr Quality ◽  
End Tidal

Background: End-tidal carbon dioxide (EtCO 2 ) is a physiologic measure that has potential to serve as an indicator of chest compression efficacy, with higher EtCO 2 values during CPR correlating with improved hemodynamics during prior laboratory studies. EtCO 2 measurement could therefore guide resuscitation efforts and help optimize CPR performance. Objective: To test the hypothesis that EtCO 2 levels positively correlate with improved chest compression rate and depth during human cardiac arrest. Methods: A prospective, observational study was conducted using a commercially available monitor/defibrillator with CPR quality and EtCO 2 sensing capabilities (MRx-QCPR, Philips Medical Systems) during in-hospital cardiac arrests at one hospital from 4/2006 until 8/2006. Resuscitation transcripts were divided into 30-second segments and mean values of chest compression rate and depth and EtCO 2 were derived for each segment. Regression analysis, with cluster-adjustment for individual patients, was used to correlate compression rate and depth with EtCO 2 . Results: Data were collected and analyzed from 281 30-second segments with a median of 12 (interquartile range: 8–33) segments per arrest from 13 consecutive patients for whom EtCO 2 and chest compression data were simultaneously available. Mean EtCO 2 was 19±7 mmHg. After adjusting for compression rate and clustering, there was a positive correlation between compression depth and EtCO 2 (regression coefficient 0.20; 95%CI [−0.01 – 0.42]). There was no significant correlation between compression rate and EtCO 2 after adjusting for compression depth and cluster, nor between survival and EtCO 2 levels. Conclusion: We found that deeper chest compressions correlated with higher EtCO 2 levels. Based on this relationship, changes in EtCO 2 during the actual resuscitation event may be reflective of the CPR quality being delivered. This work also suggests the feasibility of continuous monitoring of physiology during CPR to ensure resuscitation quality.

Sign in / Sign up

Export Citation Format

Share Document