title: Impact of adding video communication to dispatch instructions on the quality of rescue breathing in simulated cardiac arrests--a randomized controlled study.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Hui-Chih
authors.initials: HC
authors.lastname: Wang
authors.forename: Wen-Chu
authors.initials: WC
authors.lastname: Chiang
authors.forename: Wei-Tien
authors.initials: WT
authors.lastname: Chang
authors.forename: Zui-Shen
authors.initials: ZS
authors.lastname: Yen
authors.forename: Shey-Ying
authors.initials: SY
authors.lastname: Chen
authors.forename: Patrick Chow-In
authors.initials: PC
authors.lastname: Ko
authors.forename: Matthew Huei-Ming
authors.initials: MH
authors.lastname: Ma
authors.forename: Shyr-Chyr
authors.initials: SC
authors.lastname: Chen
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Fang-Yue
authors.initials: FY
authors.lastname: Lin
mesh_terms: 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*