Interactive videoconferencing versus audio telephone calls for dispatcher-assisted cardiopulmonary resuscitation using the ALERT algorithm: a randomized trial.
OBJECTIVE
The ALERT algorithm, a telephone cardiopulmonary resuscitation (CPR) protocol, has been shown to help bystanders initiate CPR. Mobile phone communications may play a role in emergency calls and improve dispatchers' understanding of the rescuer's situation. However, there is currently no validated protocol for videoconference-assisted CPR (v-CPR). We initiated this study to validate an original protocol of v-CPR and to evaluate the potential benefit in comparison with classical telephone-CPR (t-CPR).


METHODS
We developed an algorithm for v-CPR, adapted from the ALERT t-CPR protocol. A total of 180 students were recruited from secondary school and assigned randomly either to t-CPR or to v-CPR. A manikin was used to evaluate CPR performance.


RESULTS
The mean chest compression rate was higher in the v-CPR group (v-CPR: 110±16 vs. t-CPR: 86±28; P<0.0001), whereas depth was comparable between both groups (v-CPR: 48±13 vs. t-CPR: 47±16 mm; P=0.64). Hand positioning was correct in 91.7% with v-CPR, but only 68% with t-CPR (P=0.001). There was almost no 'hands-off' period in the v-CPR group [v-CPR: 0 (0-0.4) vs. t-CPR: 7 (0-25.5) s; P<0.0001], but the median no-flow time was increased in the v-CPR group [v-CPR: 146 (128-173.5) vs. t-CPR: 122 (105-143.5) s, P<0.0001]. The overall score of CPR performance was improved in the v-CPR group (P<0.001).


CONCLUSIONS
The v-CPR protocol allows bystanders to reach compression rates and depths close to guidelines and to reduce 'hands-off' events during CPR.
aFederal Public Health Services Departments of bPublic Health cMedical Informatics and Biostatistics, University of Liege dDepartment of Emergency Medicine, University Hospital of Liege, Liege, Belgium.
Samuel
S
Stipulante
Anne-Sophie
AS
Delfosse
Anne-Françoise
AF
Donneau
Gary
G
Hartsein
Sophie
S
Haus
Vincent
V
D'Orio
Alexandre
A
Ghuysen
D000328:Adult; D000465:Algorithms; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D000071822:Emergency Medical Dispatcher; D005260:Female; D006336:Heart Massage / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D049269:Videoconferencing