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Pediatric Chest Compression Improvement Via Augmented Reality Cardiopulmonary Resuscitation Feedback in Community
Keith Kleinman1, Tai Hairston2, Brittany Smith1
1Department of Pediatrics, The Johns Hopkins University, Baltimore, Maryland.
Insights
Augmented reality cardiopulmonary resuscitation (CPR) feedback significantly improved chest compression quality in community emergency departments. This novel system enhances pediatric cardiac arrest response for non-specialized teams.
Area of Science:
- Medical Simulation
- Emergency Medicine
- Pediatric Critical Care
Background:
- Over 20,000 pediatric cardiac arrests occur annually, with high-quality cardiopulmonary resuscitation (CPR) being a challenge in community hospitals.
- Existing CPR feedback systems are insufficient for pediatric emergencies.
- An augmented reality (AR) CPR feedback system was developed to address these limitations.
Purpose of the Study:
- To evaluate the effectiveness of an AR-CPR feedback system in improving chest compression (CC) performance.
- To assess AR-CPR's impact in non-pediatric-specialized community emergency departments (EDs).
Main Methods:
- An unblinded, randomized, crossover simulation-based study was conducted.
- Participants included non-pediatric nurses and technicians from community EDs.
- Participants performed simulated pediatric cardiac arrest CPR cycles, with AR-CPR utilized in randomized cycles, followed by qualitative interviews.
Main Results:
- AR-CPR use resulted in 87-90% of chest compressions being within the goal range, a significant improvement from 18-21% without feedback (p < 0.001).
- Qualitative analysis indicated AR-CPR's usability, cognitive offloading benefits, and potential to reduce anxiety and increase confidence.
- The system demonstrated effectiveness across different participant groups and randomization orders.
Conclusions:
- The AR-CPR system significantly enhanced CC performance in community hospital EDs.
- Preliminary evidence suggests AR-CPR improves the quality of CPR in non-pediatric specialized settings.
- This technology holds promise for improving outcomes in pediatric cardiac arrest events outside specialized centers.
Background:
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.
Objective:
We aimed to evaluate whether AR-CPR improves chest compression (CC) performance in non-pediatric-specialized community emergency departments (EDs).
Methods:
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.
Results:
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.
Conclusions:
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.
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