Impact of adding video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests--a randomized controlled study.
OBJECTIVE
Both ventilations and compressions are important for victims of prolonged cardiopulmonary resuscitation (CPR) and asphyxial arrest. Dispatch assistance increases bystander CPR, but the quality of dispatcher-assisted CPR (DA-CPR), especially rescue breathing, remains unsatisfactory. This study was conducted to assess the impact of adding interactive video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests.


METHODS
In this simulation-based study, adults without CPR training within 5 years were recruited between April and July 2007 and randomized to receive dispatch assistance with either voice instruction alone (voice group, n=53) or interactive voice and video instruction (video group, n=43) via a video cell phone. The quality of rescue breathing was evaluated by reviewing the videos and mannequin reports.


RESULTS
Subjects in the video group were more likely to open the airway correctly (95.3% vs. 58.5%, P<0.01) and to lift the chin properly (95.3% vs. 62.3%, P<0.01), but had similar rates of head-tilt (95.3% vs. 84.9%, P=0.10). Volunteers in the video group had larger volume of ventilation (median volume 540 ml vs. 0 ml, P<0.01), greater possibility to sustain an open airway (88.4% vs. 60.4%, P<0.01) and a tendency towards better nose-pinch (97.7% vs. 86.8%, P=0.06). The video group spent longer time to open the airway (59 s vs. 56 s, P<0.05) and to give the first rescue breathing (139 s vs. 102 s, P<0.01).


CONCLUSIONS
Adding video communication to dispatch instructions improved the quality of bystander rescue breathing, including higher proportion of airway opened, and larger volume of ventilation delivered, in simulated cardiac arrests.
Yang
Chih-Wei
CW
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
Wang
Hui-Chih
HC
Chiang
Wen-Chu
WC
Chang
Wei-Tien
WT
Yen
Zui-Shen
ZS
Chen
Shey-Ying
SY
Ko
Patrick Chow-In
PC
Ma
Matthew Huei-Ming
MH
Chen
Shyr-Chyr
SC
Chang
Shan-Chwen
SC
Lin
Fang-Yue
FY
D000328:Adult; D016887:Cardiopulmonary Resuscitation; D040421:Cell Phone; D004631:Emergency Medical Service Communication Systems; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D010043:Outcome and Process Assessment, Health Care; D019114:Remote Consultation / Q000295:instrumentation*; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D049269:Videoconferencing / Q000295:instrumentation*