title: Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests.
abstract: OBJECTIVE
  Bystander cardiopulmonary resuscitation (CPR) significantly improves survival of cardiac arrest victims. Dispatch assistance increases bystander CPR, but the quality of dispatcher-assisted CPR remains unsatisfactory. This study was conducted to assess the effect of adding interactive video communication to dispatch instruction on the quality of bystander chest compressions in simulated cardiac arrests.
  
  
  METHODS
  A randomized controlled study with a scenario developed to simulate cardiac arrest in a public place.
  
  
  METHODS
  The victim was simulated by a mannequin and the cell phone for dispatch assistance was a video cell phone with both voice and video modes. Chest compression-only CPR instruction was used in the dispatch protocol.
  
  
  METHODS
  Ninety-six adults without CPR training within 5 years were recruited.
  
  
  METHODS
  The subjects were randomized to receive dispatch assistance on chest compression with either voice instruction alone (voice group, n = 53) or interactive voice and video demonstration and feedback (video group, n = 43) via a video cell phone.
  
  
  RESULTS
  Performance of chest compression-only CPR throughout the scenario was videotaped. The quality of CPR was evaluated by reviewing the videos and mannequin reports. Chest compressions among the video group were faster (median rate 95.5 vs. 63.0 min-1, p < 0.01), deeper (median depth 36.0 vs. 25.0 mm, p < 0.01), and of more appropriate depth (20.0% vs. 0%, p < 0.01). The video group had more "hands-off" time (5.0 vs. 0 second, p < 0.01), longer time to first chest compression (145.0 vs. 116.0 seconds, p < 0.01) and total instruction time (150.0 vs. 121.0 seconds, p < 0.01).
  
  
  CONCLUSIONS
  The addition of interactive video communication to dispatcher-assisted chest compression-only CPR initially delayed the commencement of chest compressions, but subsequently improved the depth and rate of compressions. The benefit was achieved mainly through real-time feedback.
authors.affiliation: Department of Emergency Medicine, 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: Che-Wei
authors.initials: CW
authors.lastname: Hsu
authors.forename: Wei-Tien
authors.initials: WT
authors.lastname: Chang
authors.forename: Zui-Shen
authors.initials: ZS
authors.lastname: Yen
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
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D040421:Cell Phone; D035641:Chest Wall Oscillation / Q000379:methods* / Q000592:standards; D004631:Emergency Medical Service Communication Systems; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008348:Manikins; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011633:Public Facilities; D011785:Quality Assurance, Health Care; D019114:Remote Consultation / Q000295:instrumentation; D049269:Videoconferencing