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Augmented Reality-Guided Decision Support in Simulated Pediatric Cardiac Arrest: A Randomized Clinical Trial.
Johan N Siebert1,2, Adam Cheng3,4,5, Alexandre De Masi2
1Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.
JAMA Network Open
|May 22, 2026
Summary
Augmented reality (AR) decision support for pediatric cardiac arrest improved epinephrine dosing adherence but did not significantly shorten initial epinephrine times in a simulation study.
Area of Science:
- Pediatric Emergency Medicine
- Resuscitation Science
- Medical Simulation
Background:
- Pediatric in-hospital cardiac arrest (IHCA) management often deviates from best practices.
- Augmented reality (AR)-enabled, role-specific decision support may enhance adherence to American Heart Association (AHA) Pediatric Advanced Life Support (PALS) guidelines.
Purpose of the Study:
- To evaluate if an AR-enhanced, role-specific decision support system improves resuscitation performance and guideline adherence during simulated pediatric IHCA.
Main Methods:
- A multicenter, simulation-based randomized clinical trial involving pediatric nurse and physician teams.
- Teams managed a standardized pediatric IHCA scenario using either AR decision support or standard AHA PALS pocket cards.
Main Results:
- AR support did not significantly reduce the time to first epinephrine (P=.40).
- The AR group showed improved adherence to subsequent epinephrine dosing intervals (P=.03) and fewer guideline violations.
- Other performance metrics like time to defibrillation and chest compression fraction were similar between groups.
Conclusions:
- AR decision support shows potential for improving specific aspects of pediatric resuscitation, particularly medication timing adherence.
- Further research is needed to optimize AR systems for broader impact on critical care performance.
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