scholarly journals Impact of video quality when evaluating video-assisted cardiopulmonary resuscitation: a randomized, controlled simulation trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Plata ◽  
Martin Nellessen ◽  
Rebecca Roth ◽  
Hannes Ecker ◽  
Bernd W. Böttiger ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Video Sequence ◽  
Video Quality ◽  
Video Sequences ◽  
Hand Position ◽  
High Quality ◽  
Correct Evaluation ◽  
Compression Depth ◽  
Video Assisted ◽  
Significant Difference

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.

Video-assisted cardiopulmonary resuscitation: Does the camera perspective matter? A randomized, controlled simulation trial

2021 ◽  
pp. 1357633X2110284
Author(s):  
Wolfgang A. Wetsch ◽  
Hannes M. Ecker ◽  
Alexander Scheu ◽  
Rebecca Roth ◽  
Bernd W. Böttiger ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Video Sequences ◽  
Hand Position ◽  
Randomized Controlled ◽  
Video Assisted ◽  
Significant Difference ◽  
Camera Perspective ◽  
Error Recognition ◽  
Primary Hypothesis ◽  
Foot Position

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.

scholarly journals CPR with restricted patient access using alternative rescuer positions: a randomised cross-over manikin study simulating the CPR scenario after avalanche burial

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Bernd Wallner ◽  
Luca Moroder ◽  
Hannah Salchner ◽  
Peter Mair ◽  
Stefanie Wallner ◽  
...  
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
Limiting Factor ◽  
Hand Position ◽  
Patient Access ◽  
Compression Depth ◽  
Standard Position ◽  
Manikin Study ◽  
Significant Difference

Abstract Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position. Results Only 28% of all tidal volumes conformed to the guidelines (400–800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s. Conclusions Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential.

scholarly journals A comparison of the effect of two methods of positioning the hands during basic and advanced cardiovascular life support on the chest compression depth in adults

2019 ◽  
Vol 11 (4) ◽  
pp. 314-317
Author(s):  
Mohammadreza Bastami ◽  
Parand Soliemanifard ◽  
Roholla Hemmati ◽  
Golnaz Forough Ameri ◽  
Mahboobeh Rasouli ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Nursing Students ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Life Support ◽  
Dominant Hand ◽  
Compression Depth ◽  
Men And Women ◽  
Significant Difference ◽  
Left And Right

Introduction: There is no agreement on how the hands are positioned in cardiopulmonary resuscitation (CPR). In this study, the effects of two methods of positioning the hands during basic and advanced cardiovascular life support on the chest compression depth are compared.<br /> Methods: In this observational simulation, the samples included 62 nursing students and emergency medicine students trained in CPR. Each student performed two interventions in both basic and advanced situations on manikins and two positions of dominant hand on non-dominant hand, and vice versa, within four weeks. At each compression, the chest compression depth was numerically expressed in centimeter. Each student was assessed individually and without feedback.<br /> Results: The highest mean chest compression depth was related to Basic Cardiovascular Life Support (BCLS) and the position of the dominant hand on non-dominant hand (5.50 ± 0.6) and (P = 0.04). There was no statistically significant difference in the basic and advanced regression variables in men and women except in the case of Advanced Cardiovascular Life Support (ACLS) with dominant hand on non-dominant hand (P = 0.018). There was no significant difference in mean chest compression during basic and advanced cardiovascular life support in left- and right-handed individuals (P = 0.09). <br /> Conclusion: When the dominant hand is on the non-dominant hand, more pressure with greater depth is applied.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Confined Spaces ◽  
Medical Response ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods: The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compression and ventilation were conducted from behind the patient’s head. Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions: The demonstrated higher quality of CPR in the simulated research using the OTH method conducted by one person justifies the use of this method in a wider range of emergency interventions than only for CPR conducted in confined spaces.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Medical Response ◽  
Single Person ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background: Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods: The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compressions and ventilations were conducted from behind the patient’s head. Results: Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions: The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.

scholarly journals FUTUREGAN: ANTICIPATING THE FUTURE FRAMES OF VIDEO SEQUENCES USING SPATIO-TEMPORAL 3D CONVOLUTIONS IN PROGRESSIVELY GROWING GANS

2019 ◽  
Vol XLII-2/W16 ◽  
pp. 3-11 ◽  
Author(s):  
S. Aigner ◽  
M. Körner
Keyword(s):  
Video Sequence ◽  
State Of The Art ◽  
Input Sequence ◽  
Video Sequences ◽  
Complex Task ◽  
High Quality ◽  
Spatio Temporal ◽  
Resolution Single ◽  
Additional Constraints ◽  
Video Prediction

<p><strong>Abstract.</strong> We introduce a new <i>encoder-decoder GAN</i> model, <i>FutureGAN</i>, that predicts future frames of a video sequence conditioned on a sequence of past frames. During training, the networks solely receive the raw pixel values as an input, without relying on additional constraints or dataset specific conditions. To capture both the spatial and temporal components of a video sequence, spatio-temporal 3d convolutions are used in all encoder and decoder modules. Further, we utilize concepts of the existing <i>progressively growing GAN (PGGAN)</i> that achieves high-quality results on generating high-resolution single images. The FutureGAN model extends this concept to the complex task of video prediction. We conducted experiments on three different datasets, <i>MovingMNIST</i>, <i>KTH Action</i>, and <i>Cityscapes</i>. Our results show that the model learned representations to transform the information of an input sequence into a plausible future sequence effectively for all three datasets. The main advantage of the FutureGAN framework is that it is applicable to various different datasets without additional changes, whilst achieving stable results that are competitive to the state-of-the-art in video prediction. The code to reproduce the results of this paper is publicly available at https://github.com/TUM-LMF/FutureGAN.</p>

Abstract 226: Comparison of a Low and High Resource Model to Effectively Train College Students in Compression Only Cardiopulmonary Resuscitation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Matthias Goldstein ◽  
Benjamin Goldstein ◽  
Joel Novograd ◽  
Kailah Carden ◽  
Michelle Kirwan
Keyword(s):  
College Students ◽  
Cardiopulmonary Resuscitation ◽  
Training Device ◽  
Compression Depth ◽  
Training Video ◽  
Low Resource ◽  
High Resource ◽  
Significant Difference ◽  
Cpr Training ◽  
Number Of Individuals

Introduction: High quality chest compressions, as measured by depth and rate per minute, are an integral component of cardiopulmonary resuscitation (CPR). CPR compression skills are often taught on a high resource training device such as manikin torso. Use of these manikin torso devices may be limited by availability and cost, reducing the number of individuals trained in CPR. We hypothesize that a bed pillow, a low resource device, is as effective as a manikin torso, a high resource device, in training college students to perform compression only CPR. Methods: College students with no prior CPR training were randomized to one of two training rooms, one with a bed pillow (n=119) and one with a manikin torso (n=123). Each participant watched a two- minute training video, which included a demonstration using the respective device and a practice-while-watching technique chest compression skills practice. Each room had a certified CPR instructor to assist and answer any technical questions. Another CPR instructor, blinded to the training randomizations, observed each participant for one minute on a recording manikin that evaluated the depth and rate of compressions. Results: Manikin-trained students had a significantly higher mean rate of compressions per minute compared to the pillow-trained students (122.9 vs. 118.0; p= 0.028). The manikin group exceeded the recommended rate range (100-120 compressions per minute). There was no significant difference between compression depth in the two groups; manikin-trained students had an average compression depth of 38.27 mm while pillow-trained students had an average compression depth of 38.50 mm (p=0.89). Mean compression depth for both groups were below the guidelines (50-61 mm).There was no significant difference (p=0.81) between the overall CPR competency of the pillow-trained compared to the manikin-trained students as measured by rate and depth of compressions. Conclusions: These findings demonstrate that a low resource pillow is comparable to a high resource manikin as a CPR training device. The use of a low resource training device can remove the barriers of cost and availability in training college students in CPR. This training method will allow for an increase in the number of people trained to save lives.

scholarly journals Comparison of standard and over-the-head method of chest compressions during cardiopulmonary resuscitation - a simulation study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Michał Ćwiertnia ◽  
Marek Kawecki ◽  
Tomasz Ilczak ◽  
Monika Mikulska ◽  
Mieczysław Dutka ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Artificial Ventilation ◽  
Hand Position ◽  
Chest Compressions ◽  
Medical Response ◽  
Single Person ◽  
Significant Difference ◽  
Emergency Interventions

Abstract Background Maintaining highly effective cardiopulmonary resuscitation (CPR) can be particularly difficult when artificial ventilation using a bag-valve-mask device, combined with chest compression have to be carried out by one person. The aim of the study is to compare the quality of CPR conducted by one paramedic using chest compression from the patient’s side with compression conducted from the ‘over-the-head’ position. Methods The subject of the study were two methods of CPR – ‘standard’ (STD) and ‘over-the-head’ (OTH). The STD method consisted of cycles of 30 chest compressions from the patient’s side, and two attempts at artificial ventilation after moving round to behind the patient’s head. In the OTH method, both compressions and ventilations were conducted from behind the patient’s head. Results Both CPR methods were conducted by 38 paramedics working in medical response teams. Statistical analysis was conducted on the data collected, giving the following results: the average time of the interruptions between compression cycles (STD 9.184 s, OTH 7.316 s, p < 0.001); the depth of compression 50–60 mm (STD 50.65%, OTH 60.22%, p < 0.001); the rate of compression 100–120/min. (STD 46.39%, OTH 53.78%, p < 0.001); complete chest wall recoil (STD 84.54%, OTH 91.46%, p < 0.001); correct hand position (STD 99.32%, OTH method 99.66%, p < 0.001). A statistically significant difference was demonstrated in the results to the benefit of the OTH method in the above parameters. The remaining parameters showed no significant differences in comparison to reference values. Conclusions The higher quality of CPR in the simulated research using the OTH method by a single person justifies the use of this method in a wider range of emergency interventions.

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 Two-Thumb or Two-Finger Technique in Infant Cardiopulmonary Resuscitation by a Single Rescuer? A Meta-Analysis with GOSH Analysis

2020 ◽  
Vol 17 (14) ◽  
pp. 5214
Author(s):  
Chun-Yu Chang ◽  
Yueh-Tseng Hou ◽  
Yung-Jiun Chien ◽  
Yu-Long Chen ◽  
Po-Chen Lin ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cardiopulmonary Arrest ◽  
Meta Analysis ◽  
Compression Rate ◽  
Cochrane Central Register ◽  
Compression Depth ◽  
Neurological Outcomes ◽  
Central Register ◽  
Significant Difference ◽  
Off Time

Out-of-hospital infant cardiopulmonary arrest is a fatal and uncommon event. High mortality rates and poor neurological outcomes may be improved by early cardiopulmonary resuscitation (CPR). The ongoing debate over two different infant CPR techniques, the two-thumb (TT) and the two-finger (TF) technique, has remained, especially in terms of the adequate compression depth, compression rate, and hands-off time. In this article, we searched three major databases, PubMed, EMBASE (Excerpta Medica database), and CENTRAL (Cochrane Central Register of Controlled Trials), for randomized control trials which compared the outcomes of interest between the TT and TF techniques in infant CPR. The results showed that the TT technique was associated with higher proportion of adequate compression depth (Mean difference (MD): 19.99%; 95%, Confidence interval (CI): 9.77 to 30.22; p < 0.01) than the TF technique. There was no significant difference in compression rate and hands-off time. In our conclusion, the TT technique is better in terms of adequate compression depth than the TF technique, without significant differences in compression rate and hands-off time.

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