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Video-assisted dispatcher support in cardiopulmonary resuscitation (VA-CPR) has shown beneficial effects on CPR quality. This study examines the influence of professional background on the ability to identify typical errors in CPR performance using video-based assessments. Within this simulation-based observational study, 61 participants (31 EMS personnel, 30 emergency physicians) evaluated nine video sequences showing simulated CPR or ventilation. Participants were grouped by profession, not randomly. The primary endpoint was the correct identification of expert-defined errors in the presented videos, analyzed in relation to professional background. Evaluation accuracy for CPR and ventilation videos was examined in relation to participant characteristics. Overall, n  = 427 CPR videos were correctly classified in 73.3% of cases by EMS personnel and 75.7% by emergency physicians (β = 0.370, SE = 0.297, 95% CI: −0.21 to 0.95, p  = 0.213). Ventilation scenarios ( n  = 122) were correctly classified in 93.5% (EMS) and 98.3%, (EP) (β = 4.50, SE = 6.73, 95% CI: −8.82 to 17.82, p  = 0.505). The models assessing classification accuracy for CPR and ventilation did not reach statistical significance (p CPR =0.869 and p ventilation =0.183), and none of the tested predictors were significantly associated with evaluation accuracy. No significant differences in evaluation accuracy for CPR and ventilation videos were observed between professional groups or across tested participant characteristics.

AbstractIntroductionConsidering the few studies evaluating bystander cardiopulmonary resuscitation (CPR) performance, we sought to analyze differences in bystander CPR performance with and without the use of our self-developed animated GIFs based on dispatcher-assisted CPR simulation. MethodsA total of 80 adults who had not received CPR training over the past two years participated in the study. Among them, 40 people were classified into the auditory group (receiving CPR instructions only over the phone), and the other 40 people were classified into the audiovisual group (receiving CPR instructions over the phone after receiving images on a smartphone). All participants were asked to perform adult and infant CPR for 2 min. CPR performance was recorded using two video cameras (front and side) and analyzed by two emergency physicians, whereas CPR quality was measured using Resusci Anne & Baby QCPR Mk II (Laerdal). ResultsIn the adult CPR study, the audiovisual group had higher performance scores for adequacy of “knee position,” “hand posture,” “elbow extension,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores ( p < 0.001). No significant difference in CPR quality was observed between the two groups. In the infant CPR study, audiovisual group had higher performance scores in adequacy of “compression site,” “finger posture,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores ( p < 0.001). Regarding CPR quality, the audiovisual group had higher scores for “adequate compression rate ratio” ( p = 0.047). ConclusionAudiovisual guidance using animated GIFs more effectively improved CPR Standard Posture Completeness and Instruction Performance than did traditional auditory guidance.

High quality chest compressions are essential for survival and good neurological outcome in out-of-hospital cardiac arrest (OHCA). Dispatcher- assisted CPR (DA-CPR) has led to increased survival in OHCA. Recently, additional verbal motivation has shown positive effects on CPR quality. The present randomized and controlled simulation trial investigates the effect of different intervals of verbal motivation during DA-CPR. 159 medical laypersons performed eight minutes of CPR on a simulator after randomization into one of three study groups: 1) “DA-CPR” 2) “DA-CPR + motivation every 30s” 3) “DA-CPR + motivation every 60s”. Verbal motivation consisted of “push harder, do not relent. Additionally, a metronome beat was audible via telephone in the motivation groups. Primary endpoint was the difference in median chest compression depth during the eight-minute CPR compared between the study groups. There were significant differences in median compression depth between the three study groups (p = 0.002). However, only the group “DA-CPR + motivation every 60s” showed a significant difference in compression depth compared to standard DA-CPR and was within the recommended range. Compressions with adequate depth (p = 0.009) and median compression rate (p < 0.001) were significantly elevated in both motivational groups compared to the “DA-CPR”-group. Verbal encouragement every 30 or 60 s combined with a metronome beat led to a significant augmentation of chest compression depth compared to standard DA-CPR. •Verbal motivation during dispatcher-assisted CPR increases chest compression depth.•Using motivational feedback too often does not further increase compression depth.•Cumulative no-flow time can be highly reduced through verbal motivation.•Our algorithm is simple and therefore easy to implement in existing structures.

Background For many years, bystander cardiopulmonary resuscitation (BCPR) has been considered as a favorable factor to improve survival of out-of-hospital cardiac arrests (OHCAs). To examine the effect of BCPR on the survival of OHCAs and whether BCPR might also improve survival when the initial rhythm of OHCAs is limited, we performed a meta-analysis on published observational studies. Methods We did a systematic review to identify all studies published up to March, 2018, in any language, that reported the relation between BCPR and the survival of OHCAs. Using standard forms, two authors independently identified studies for inclusion and extracted information. The outcome was survival. Meta-regression was done to ascertain weighted factors for the outcomes. Results Data were extracted from 19 studies involving 232,703 patients. Firstly, pooled odds ratio (OR) from 16 cohort studies showed that BCPR was associated with improved chance of survival of OHCAs compared with NO-BCPR (OR 1.95, 95% confidence interval [CI]: 1.66–2.30). Secondly, from 8 cohort studies of OHCAs whose initial rhythm is limited, the pooled OR was 2.10 (95% CI, 1.68–2.63) of 6 articles for shockable rhythm and 1.07 (95% CI, 0.37–3.13) of 2 articles for non-shockable rhythm. Meta-regression showed a relation between the survival of OHCAs and BCPR was influenced by area ( p  < 0.05). Conclusions Based on currently available evidence, the findings of this meta-analysis suggest that BCPR increases the survival of OHCAs, and it also help OHCAs whose initial rhythm is shockable. That is to say BCPR is also helpful when emergency department response time is short. Therefore global priority should be given to increasing the incidence of BCPR by evidence-based best practice.

Evaluating the usefulness of a chat bot as an assistant during CPR care by laypersons. Twenty-one university graduates and university students naive in basic life support participated in this quasi-experimental simulation pilot trial. A version beta chatbot was designed to guide potential bystanders who need help in caring for cardiac arrest victims. Through a Question-Answering (Q&A) flowchart, the chatbot uses Voice Recognition Techniques to transform the user's audio into text. After the transformation, it generates the answer to provide the necessary help through machine and deep learning algorithms. A simulation test with a Laerdal Little Anne manikin was performed. Participants initiated the chatbot, which guided them through the recognition of a cardiac arrest event. After recognizing the cardiac arrest, the chatbot indicated the start of chest compressions for 2 min. Evaluation of the cardiac arrest recognition sequence was done via a checklist and the quality of CPR was collected with the Laerdal Instructor App. 91% of participants were able to perform the entire sequence correctly. All participants checked the safety of the scene and made sure to call 112. 62% place their hands on the correct compression point. A media time of 158 s (IQR: 146–189) was needed for the whole process. 33% of participants achieved high-quality CPR with a median of 60% in QCPR (IQR: 9–86). Compression depth had a median of 42 mm (IQR: 33–53) and compression rate had a median of 100 compressions/min (IQR: 97–100). The use of a voice assistant could be useful for people with no previous training to perform de out-of-hospital cardiac arrest recognition sequence. Chatbot was able to guide all participants to call 112 and to perform continuous chest compressions. The first version of the chatbot for potential bystanders naive in basic life support needs to be further developed to reduce response times and be more effective in giving feedback on chest compressions. •The use of different chatbots has been increasing in recent years.•Some OHCA witnesses may ask a chatbot for help instead of calling the EMS number.•It could be interesting that if you ask a chatbot for help, it could help you save lives.•The use of a chatbot can help in the treatment of OHCA by untrained bystanders.•The time to start CPR and quality CPR can be improved, but all participants provide help.

Introduction The early commencement of effective resuscitation is of fundamental importance for the survival of individuals experiencing out-of-hospital cardiac arrest. In such circumstances, video-assisted guidance by the dispatcher has been demonstrated to be advantageous for the recognition of cardiac arrest and the improvement of CPR quality. The present study investigates the effectiveness of a brief training program for control center dispatchers in the recognition of common errors during simulated resuscitation. Methods The study was approved by the local ethics committee and registered at the German Clinical Trial Register on 27th of February 2024 (Registration number: DRKS00032661) prior to inclusion of the first participant. Within a two-armed group study design, paramedics and emergency physicians were randomly assigned to either an experimental group ( n  = 44) or a control group ( n  = 44). The experimental group was initially exposed to a targeted brief training aimed at enhancing the recognition of excessively deep chest compression depth. All participants evaluated 42 distinct video sequences showing seven typical errors during CPR. The shown CPRs were simulated on a training manikin and the videos were evaluated by the participants under laboratory conditions. The primary endpoint was the accurate evaluation of the presented videos with too deep compression depth in a laboratory setting. Results A total of 3696 video sequences were evaluated. The experimental group demonstrated a significantly higher recognition rate for too deep chest compressions compared to the control group (87.9% vs. 59.2%, p  < 0.001). With regard to the remaining errors, no significant differences were observed between the study groups. Overall, 2861 of the 3696 videos (77.7%) were correctly classified. The proportion of correctly classified videos was significantly higher in the experimental group compared to the control group (79.8% vs. 75.6%, p  = 0.003), indicating a statistically significant effect of the intervention. Conclusion The identification of chest compressions with too deep compression depth in a video of simulated CPR was found to increase significantly in evaluators who had undergone a brief training course. Trial registration The trial was registered in the German Clinical Trial Register “BfArM - Deutsches Register Klinischer Studien (DRKS)” under the registration number DRKS00032661.

Considering the few studies evaluating bystander cardiopulmonary resuscitation (CPR) performance, we sought to analyze differences in bystander CPR performance with and without the use of our self-developed animated GIFs based on dispatcher-assisted CPR simulation. A total of 80 adults who had not received CPR training over the past two years participated in the study. Among them, 40 people were classified into the auditory group (receiving CPR instructions only over the phone), and the other 40 people were classified into the audiovisual group (receiving CPR instructions over the phone after receiving images on a smartphone). All participants were asked to perform adult and infant CPR for 2 min. CPR performance was recorded using two video cameras (front and side) and analyzed by two emergency physicians, whereas CPR quality was measured using Resusci Anne & Baby QCPR Mk II (Laerdal). In the adult CPR study, the audiovisual group had higher performance scores for adequacy of “knee position,” “hand posture,” “elbow extension,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). No significant difference in CPR quality was observed between the two groups. In the infant CPR study, audiovisual group had higher performance scores in adequacy of “compression site,” “finger posture,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). Regarding CPR quality, the audiovisual group had higher scores for “adequate compression rate ratio” (p = 0.047). Audiovisual guidance using animated GIFs more effectively improved CPR Standard Posture Completeness and Instruction Performance than did traditional auditory guidance. [Display omitted]

Sudden cardiac arrest is a leading cause of death in the United States, with many occurring out of the hospital. Immediate response by bystanders, through the initiation of cardiopulmonary resuscitation (CPR), leads to increased survival; however, many do not respond due to lack of training and education. This study sought to determine the efficacy of a training model developed to rapidly and effectively train large numbers of individuals on hands-only CPR. Thirty minute training sessions were developed to introduce hands-only CPR to faculty at a university, with questionnaires assessing confidence and knowledge of CPR. Faculty then went on to train their respective students. Ninety-six faculty and staff and 1615 students were trained within 3 weeks, demonstrating this model was effective in rapidly training large numbers of individuals in a short period of time while increasing CPR knowledge and confidence. This method may be effective in other community settings.

Background Out-of-hospital cardiac arrest is a public health crisis affecting about 356,000 adults and 23,000 children annually in the US with 90% fatality. Early bystander CPR and AED application improve survival. Less than 3% of the US population is CPR trained annually. Since 20% of the US population is at school daily, these represent ideal places to target CPR training. Having standardized state school CPR and AED laws will help with training. Methods We performed a systemic search of the state-specific laws for school AED and CPR requirements within the US. We used PubMed and Google search using keywords: school CPR mandates, US laws for CPR in schools, US state laws for AED implementation, and gaps in US school CPR and AED. We searched for mandates for schools in other countries for comparison. Results The state laws for CPR training for high school graduation and AED requirements in US. schools are highly variable, and funding for AEDs is inadequate, especially in schools in lower socio-economic zip codes. Recent AED legislative efforts focus mainly on athletic areas and don’t adequately address school size, number of buildings, non-athletic areas, and engagement of student-led advocacy efforts. Conclusion To improve OHCA survival, we identified potential solutions to consolidate efforts and overcome the barriers—standardize state laws, involve student bodies, increase funding, and allocate appropriate resources. The CPR/AED education needs to start earlier in schools and be part of the standard curriculum rather than implemented as a stopgap check-box mandate.