Department of Pediatric Critical Care, Children's National Hospital, Washington DC, United States of America.
Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington DC, United States of America.
Am J Emerg Med. 2022 Oct;60:34-39. doi: 10.1016/j.ajem.2022.06.045. Epub 2022 Jun 26.
Quality of cardiopulmonary resuscitation (CPR) contributes significantly to outcomes. Key determinants of CPR quality pertaining to chest compressions are compression rate, compression depth, duration of interruptions, and chest recoil. Several studies have demonstrated that real-time audiovisual feedback improves CPR quality. We hypothesize that a mobile application using sensor data from built-in accelerometers in smartphones can provide accurate chest compression quality feedback in real time. This study aims to develop and validate an application for smartphone which can provide real-time audiovisual and haptic feedback on determinants of CPR quality.
A mobile application was developed to detect the compression depth and compression rate in real time using data captured from a smartphone's intrinsic accelerometer. The mobile device was placed on an adult manikin's chest at the point of compressions. In a simulated environment, data obtained using the application was compared directly to data obtained from a validated standard CPR quality tool.
CPR quality parameters were obtained from the application and industry standard for 60, 30s-long sessions. Bland-Altman plot analysis for compression depth showed agreement between the app measurements and standard within ±4 mm (<10% error). The interclass correlation for agreement in the measurement of compression count was 0.92 (95% CI: 0.88-0.95), indicative of very strong agreement.
Smart device applications using acceleration sensor data derived from smart phones can accurately provide real-time CPR quality feedback. With further development and validation, they can provide a ubiquitously available CPR feedback tool valuable for out-of-hospital arrests and in-hospital arrests in under-privileged areas.
心肺复苏术（CPR）的质量对结果有重大影响。与胸外按压相关的 CPR 质量的关键决定因素是按压频率、按压深度、中断时间和胸部回弹。多项研究表明，实时视听反馈可提高 CPR 质量。我们假设，使用智能手机内置加速度计的传感器数据的移动应用程序可以实时提供准确的胸外按压质量反馈。本研究旨在开发和验证一种智能手机应用程序，该程序可以实时提供有关 CPR 质量决定因素的视听和触觉反馈。
开发了一种移动应用程序，通过智能手机内置加速度计捕获的数据实时检测按压深度和按压频率。将移动设备放置在成人模拟人胸部的按压点上。在模拟环境中，应用程序获得的数据与经过验证的标准 CPR 质量工具获得的数据直接进行比较。
应用程序和行业标准获得了 60 秒和 30 秒长的 CPR 质量参数。应用程序测量值与标准值之间的压缩深度 Bland-Altman 图分析表明在±4mm 以内（<10%误差）一致。压缩计数测量值的一致性的组内相关系数为 0.92（95%置信区间：0.88-0.95），表明非常强的一致性。
使用智能手机加速度计数据的智能设备应用程序可以准确地提供实时 CPR 质量反馈。随着进一步的开发和验证，它们可以提供一种无处不在的 CPR 反馈工具，对院外和贫困地区院内的心脏骤停都有价值。
