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A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

ABSTRACT: Our randomized controlled simulation study aimed to compare the CPR quality, time-related factors, attitude and self-assessment of non-healthcare university students (aged 18-25) compared video-assisted (V-CPR, n = 50) with telephone-assisted (T-CPR, n = 49) and unassisted (U-CPR, n = 48) CPR in a simulation setting. Regarding to chest compression depth, no difference was found between the three groups (p = 0.065): 41.8 mm, SD = 9.9 in the V-CPR; 35.9 mm, SD = 11.6 in the T-CPR; and 39.4 mm, SD = 15.6 in the U-CPR group. The mean chest compression rate was the best in the V-CPR group (100.9 min^-1, SD = 17.1) which was superior to the T-CPR (82.4 min^-1, SD = 35.4; p = 0.005), and the U-CPR (84.2 min^-1, SD = 30.6; p = 0.013) groups. The overall proportion of correct hand position was the highest in the V-CPR group (48, 96%), compared to the T-CPR (28, 57.1%; p = 0.001), and the U-CPR (34, 70.8%; p = 0.001) groups. V-CPR led to a delay in the time to the first chest compression compared with the U-CPR group (77.5 s, SD = 19.2 vs. 31.3 s, SD = 13.3, p < 0.001). Although V-CPR technology holds the potential to improve overall CPR quality, the importance of appropriate chest compression depth should be emphasized in training for laypeople and dispatchers, as well. Our study was registered at ClinicalTrials.gov (NCT05639868, 06/12/2022).

SUBMITTER: Szollosi V

PROVIDER: S-EPMC10495456 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

Szöllősi Vivien V Horváth Balázs B Németh Dániel D Bánfai-Csonka Henrietta H Betlehem József J Bánfai Bálint B

Scientific reports 20230911 1

Our randomized controlled simulation study aimed to compare the CPR quality, time-related factors, attitude and self-assessment of non-healthcare university students (aged 18-25) compared video-assisted (V-CPR, n = 50) with telephone-assisted (T-CPR, n = 49) and unassisted (U-CPR, n = 48) CPR in a simulation setting. Regarding to chest compression depth, no difference was found between the three groups (p = 0.065): 41.8 mm, SD = 9.9 in the V-CPR; 35.9 mm, SD = 11.6 in the T-CPR; and 39.4 mm, SD ...[more]

PMID: 37696968

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Project description:ObjectivesTo evaluate the effectiveness of in situ simulation for cardiopulmonary resuscitation (CPR) training on clinical and educational outcomes.MethodsRandomised controlled trials (RCT) and non-randomised studies evaluating in situ simulation for cardiopulmonary resuscitation CPR training of healthcare workers in any setting compared to traditional training and reporting data on patients' survival, patients' outcomes, clinical performance and teamwork in actual or simulated resuscitation and resources needed were included. PubMed, Embase and Cochrane were searches from inception to October 28th 2024 (PROSPERO CRD42024521780). The assessment of risk of bias was done using RoB2 or ROBINS-I and the certainty of evidence was assessed by the GRADE approach. Meta-analysis was not possible due to significant heterogeneity in setting, interventions, control, and outcome definitions. The evidence was summarised according to the Synthesis Without Meta-Analysis (SwiM) reporting guidelines. No funding has been obtained.ResultsFrom 1062 records, 10 articles were included after full-text review (4 RCTs, 6 non-randomised). The risk of bias was judged as high or some concerns for RCTs and critical or serious for non-randomised studies. The certainty of evidence was very low for all the evaluated outcomes mainly due to risk of bias, inconsistency and imprecision. Two non-randomised studies reported data on patient survival, while two other non-randomized studies provided data on the review outcome of 'patient outcomes', suggesting a potential benefit of in situ simulation or no difference. Four non-randomised studies reported improving or no difference in clinical performance in actual resuscitation. One study reported improved teamwork in actual resuscitation while another reported no difference. Most included studies reported improved clinical performance, teamwork and CPR skill in simulated resuscitation after in situ simulation training vs. traditional training. No study evaluated the resources needed.ConclusionThe heterogenous evidence suggests that in situ simulation should be considered as an option for CPR training. The certainty of evidence is very low and cost-benefit balance is uncertain due to lack of data about resource needed.

Project description:IntroductionEarly defibrillation is an important factor of survival in cardiac arrest. However, novice resuscitators often struggle with cardiac arrest patients. We investigated factors leading to delayed defibrillation performed by final-year medical students within a simulated bystander cardiac arrest situation.MethodsFinal-year medical students received a refresher lecture and basic life support training before being confronted with a simulated cardiac arrest situation in a simulation ambulance. The scenario was analyzed for factors leading to delayed defibrillation. We compared the time intervals the participants needed for various measures with a benchmark set by experienced resuscitators. After training, the participants were interviewed regarding challenges and thoughts during the scenario.ResultsThe median time needed for defibrillation was 158 s (n = 49, interquartile range: 107-270 s), more than six-fold of the benchmark time. The major part of total defibrillation time (49%; median, n = 49) was between onset of ventricular fibrillation and beginning to prepare the defibrillator, more specifically the time between end of preparation of the defibrillator and actual delivery of the shock, with a mean proportion of 26% (n = 49, SD = 17%) of the overall time needed for defibrillation (maximum 67%). Self-reported reasons for this delay included uncertainty about the next step to take, as reported by 73% of the participants. A total of 35% were unsure about which algorithm to follow. Diagnosing the patient was subjectively difficult for 35% of the participants. Overall, 53% of the participants felt generally confused.ConclusionsOur study shows that novice resuscitators rarely achieve guideline-recommended defibrillation times. The most relative delays were observed when participants had to choose what to do next or which algorithm to follow, and thus i.e. performed extensive airway management before a life-saving defibrillation. Our data provides a first insight in the process of defibrillation delay and can be used to generate new hypotheses on how to provide a timely defibrillation.

Dataset Information

A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

Publications

A randomized controlled simulation trial comparing video-assisted with telephone-assisted and unassisted cardiopulmonary resuscitation performed by non-healthcare university students.

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