Effect of a real-time feedback smartphone application (TCPRLink) on the quality of telephone-assisted CPR performed by trained laypeople in China: a manikin-based randomised controlled study

• Published in: BMJ open Vol. 10; no. 10; p. e038813
• Main Authors: Dong, Xuejie, Zhang, Lin, Myklebust, Helge, Birkenes, Tonje Soraas, Zheng, Zhi-Jie
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 05-10-2020; BMJ Publishing Group
• Series: Original research
• Subjects: Adolescent; Adult; Age; Aged; Cameras; Cardiopulmonary Resuscitation; China; CPR; Emergency Medicine; Feedback; Humans; Manikins; Middle Aged; Public health; Simulation; Smartphone; Smartphones; Telemedicine; Telephone; Young Adult; China; Norway; accident & emergency medicine; telemedicine; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-038813

ObjectivesTo determine the effect of a free smartphone application (TCPRLink) that provides real-time monitoring and audiovisual feedback on chest compressions (CC) on trained layperson telephone-assisted cardiopulmonary resuscitation (T-CPR) performance.DesignA manikin-based randomised controlled study.SettingThis study was conducted at a multidisciplinary university and a community centre in China.ParticipantsOne hundred and eighty-six adult participants (age 18–65 years) with T-CPR training experience were randomly assigned to the TCPRLink (n=94) and T-CPR (n=92) groups with age stratification.InterventionsWe compared the participants’ performance for 6 min of CC in a simulated T-CPR scenario both at the baseline and after 3 months.Primary and secondary outcome measuresThe primary outcomes were the CC rate and proportion of adequate CC rate (100–120 min−1). The secondary outcomes included the proportion of participants counting the CC rhythm, time to first CC, CC depth, hands-off time and CC full-release ratio.ResultsParticipants in the TCPRLink feedback group more consistently performed CC with higher rate, both initially and 3 months later (median 111 (IQR 109–113) vs 108 (103–112) min−1, p=0.002 and 111 (109–113) vs 108 (105–112) min−1, p<0.001, respectively), with less need to count the rhythm (21.3% vs 41.3%, p=0.003% and 7% vs 22.6%, p=0.004, respectively) compared with the T-CPR group. There were no significant differences in time to the first CC, hands-off time or CC full-release ratio. Among 55–65 year group, the CC depth was deeper in the TCPRLink group than in the TCPR group (47.1±9.6 vs 38.5±8.7 mm, p=0.001 and 44.7±10.1 vs 39.3±10.8 mm, p=0.07, respectively).ConclusionsThe TCPRLink application improved T-CPR quality in trained laypersons to provide more effective CCs and lighten the load of counting out the CC with the dispatcher in a simulated T-CPR scenario. Further investigations are required to confirm this effectiveness in real-life resuscitation attempts.