Department of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany.
Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany.
Scand J Trauma Resusc Emerg Med. 2021 Jun 3;29(1):76. doi: 10.1186/s13049-021-00893-3.
Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a beneficial addition to traditional resuscitation training?
In this controlled trial, we assessed the impact of app use on the quality of resuscitation (hands-off time, assessment of the patient's condition, quality of chest compression, body and arm positioning). Pupils who have previously undergone a standardised resuscitation training, encountered a simulated cardiac arrest either (i) without an app (control group); (ii) with facultative app usage; or (iii) with mandatory app usage. Measurements were compared using generalised linear regression.
200 pupils attended this study with 74 pupils in control group, 65 in facultative group and 61 in mandatory group. Participants who had to use the app significantly delayed the check for breathing, call for help, and first compression, leading to longer total hands-off time. Hands-off time during chest compression did not differ significantly. The percentage of correct compression rate and correct compression depth was significantly higher when app use was mandatory. Assessment of the patient's condition, and body and arm positioning did not differ.
Smartphone apps offering real-time guidance in resuscitation can improve the quality of chest compression but may also delay the start of resuscitation. Provided that the app gives easy-to-implement, guideline-compliant instructions and that the user is familiar with its operation, we recommend smartphone-guidance as an additional tool to hands-on CPR-training to increase the prevalence and quality of bystander-initiated CPR.
旁观者启动的复苏对于院外心脏骤停的存活至关重要。智能手机应用程序可为这些情况下的医学外行提供实时指导。这些应用程序是否是传统复苏培训的有益补充？
在这项对照试验中，我们评估了应用程序使用对复苏质量（脱手时间、患者状况评估、胸外按压质量、身体和手臂定位）的影响。先前接受过标准化复苏培训的学员遇到模拟心脏骤停时，（i）未使用应用程序（对照组）；（ii）选择性使用应用程序；或（iii）必须使用应用程序。使用广义线性回归比较测量值。
200 名学员参加了这项研究，其中对照组 74 名学员，选择性组 65 名学员，强制性组 61 名学员。必须使用应用程序的参与者明显延迟了对呼吸、呼救和首次按压的检查，导致总脱手时间延长。胸外按压期间的脱手时间无显著差异。当应用程序的使用是强制性时，正确的按压率和正确的按压深度百分比显著更高。患者状况评估以及身体和手臂定位无差异。
提供复苏实时指导的智能手机应用程序可以提高胸外按压质量，但也可能延迟复苏的开始。只要应用程序提供易于实施且符合指南的说明，并且用户熟悉其操作，我们就建议将智能手机指导作为增加旁观者启动 CPR 的流行率和质量的附加工具，以用于动手心肺复苏培训。
