Department of Pediatrics, The Johns Hopkins University, Baltimore, Maryland.
The Harriet Lane Pediatric Residency Program, The Johns Hopkins University, Baltimore, Maryland.
J Emerg Med. 2023 Jun;64(6):696-708. doi: 10.1016/j.jemermed.2023.03.058. Epub 2023 Mar 22.
Yearly, more than 20,000 children experience a cardiac arrest. High-quality pediatric cardiopulmonary resuscitation (CPR) is generally challenging for community hospital teams, where pediatric cardiac arrest is infrequent. Current feedback systems are insufficient. Therefore, we developed an augmented reality (AR) CPR feedback system for use in many settings.
We aimed to evaluate whether AR-CPR improves chest compression (CC) performance in non-pediatric-specialized community emergency departments (EDs).
We performed an unblinded, randomized, crossover simulation-based study. A convenience sample of community ED nonpediatric nurses and technicians were included. Each participant performed three 2-min cycles of CC during a simulated pediatric cardiac arrest. Participants were randomized to use AR-CPR in one of three CC cycles. Afterward, participants participated in a qualitative interview to inquire about their experience with AR-CPR.
Of 36 participants, 18 were randomized to AR-CPR in cycle 2 (group A) and 18 were randomized to AR-CPR in cycle 3 (group B). When using AR-CPR, 87-90% (SD 12-13%) of all CCs were in goal range, analyzed as 1-min intervals, compared with 18-21% (SD 30-33%) without feedback (p < 0.001). Analysis of qualitative themes revealed that AR-CPR may be usable without a device orientation, be effective at cognitive offloading, and reduce anxiety around and enhance confidence in the CC delivered.
The novel CPR feedback system, AR-CPR, significantly changed the CC performance in community hospital non-pediatric-specialized general EDs from 18-21% to 87-90% of CC epochs at goal. This study offers preliminary evidence suggesting AR-CPR improves CC quality in community hospital settings.
每年有超过 20000 名儿童经历心脏骤停。对于社区医院团队来说，高质量的儿科心肺复苏术（CPR）通常具有挑战性，因为儿科心脏骤停并不常见。目前的反馈系统还不够完善。因此，我们开发了一种增强现实（AR）CPR 反馈系统，可用于多种场景。
我们旨在评估 AR-CPR 是否能提高非儿科专业社区急诊部（ED）的胸外按压（CC）效果。
我们进行了一项非盲、随机、交叉模拟研究。纳入了社区 ED 的非儿科护士和技术员的便利样本。每位参与者在模拟儿科心脏骤停期间进行了三个 2 分钟的 CC 循环。参与者被随机分配在三个 CC 循环中的一个中使用 AR-CPR。之后，参与者参加了定性访谈，以询问他们使用 AR-CPR 的体验。
在 36 名参与者中，有 18 名随机分配到 CC 循环 2 中使用 AR-CPR（A 组），18 名随机分配到 CC 循环 3 中使用 AR-CPR（B 组）。使用 AR-CPR 时，87-90%（SD 12-13%）的 CC 都在目标范围内，分析为 1 分钟间隔，而没有反馈时则为 18-21%（SD 30-33%）（p<0.001）。对定性主题的分析表明，AR-CPR 可能无需设备定向即可使用，可有效减轻认知负担，并减少对 CC 的焦虑，同时增强对 CC 的信心。
新型 CPR 反馈系统 AR-CPR 可将社区医院非儿科专业普通 ED 中的 CC 从 18-21%提高到 87-90%，有效提高 CC 质量。本研究初步证明了 AR-CPR 可提高社区医院环境中的 CC 质量。
