Real-Time Mobile Device–Assisted Chest Compression During Cardiopulmonary Resuscitation

Abstract

Prompt administration of high-quality cardiopulmonary resuscitation (CPR) is a key determinant of survival from cardiac arrest. Strategies to improve CPR quality at point of care could improve resuscitation outcomes. We tested whether a low cost and scalable mobile phone- or smart watch-based solution could provide accurate measures of compression depth and rate during simulated CPR. Fifty health care providers (58% intensive care unit nurses) performed simulated CPR on a calibrated training manikin (Resusci Anne, Laerdal) while wearing both devices. Subjects received real-time audiovisual feedback from each device sequentially. Primary outcome was accuracy of compression depth and rate compared with the calibrated training manikin. Secondary outcome was improvement in CPR quality as defined by meeting both guideline-recommend compression depth (5 to 6cm) and rate (100 to 120/minute). Compared with the training manikin, typical error for compression depth was <5mm (smart phone 4.6mm; 95% CI 4.1 to 5.3mm; smart watch 4.3mm; 95% CI 3.8 to 5.0mm). Compression rates were similarly accurate (smart phone Pearson's R= 0.93; smart watch R= 0.97). There was no difference in improved CPR quality defined as the number of sessions meeting both guideline-recommended compression depth (50 to 60mm) and rate (100 to 120 compressions/minute) with mobile device feedback (60% vs 50%; p= 0.3). Sessions that did not meet guideline recommendations failed primarily because of inadequate compression depth (46 ± 2mm). In conclusion, a mobile device application-guided CPR can accurately track compression depth and rate during simulation in a practice environment in accordance with resuscitation guidelines.