Smartphone Apps to Support Laypersons in Bystander CPR Are of Ambivalent Benefit: a Randomized Controlled Trial Using Medical Simulation
Abstract Background: Bystander initiated resuscitation is essential. To encourage medical laypersons to perform resuscitation smartphone apps providing real-time guidance were invented. Are these apps a beneficial addition to traditional resuscitation training?Methods: In a randomized controlled trial impact of app usage on quality of resuscitation in a standardised simulated cardiac arrest scenario was assessed. In a previous study the app “HELP Notfall” was selected for this purpose. Six weeks after a standardised resuscitation training pupils encountered a simulated cardiac arrest (i) without app (control group); (ii) with facultative app usage (facultative group); (iii) with mandatory app usage (mandatory group).Results: 200 pupils attended this study with 74 pupils (37%) in control group, 65 (32,5%) in facultative group and 61 (30,5%) in mandatory group. Participants using the app in mandatory group had a significantly higher percentage of chest compressions with the correct compression rate (65.4% vs. 43.8%; p<0.01) and with correct compression depth (47.6% vs. 24.4%; p=0.001) than pupils of the control group. Participants of the mandatory group had a significant delay compared with control group regarding time until check for breathing (23 sec. vs. 12 sec., p<0.001), call for help (35 sec. vs. 20 sec., p<0.001) and first compression (68 sec. vs. 29 sec., p<0.001). Hands-off-time during compression tended to be shorter in mandatory group (0.5 sec.) compared with control group (1.5 sec.), (p=0.36).Conclusions: Smartphone apps offering real-time guidance in resuscitation are of mixed benefits. An improved quality of chest compression is countered by a delayed start of chest compressions. Both aspects have to be considered before recommending smartphone apps to support laypersons in bystander resuscitation as an addition to traditional hands-on training.