Effectiveness of feedback with a smartwatch for high-quality chest compressions during adult cardiac arrest: A randomized controlled simulation study

Abstract

Previous studies have demonstrated the potential for using smartwatches with a built-in accelerometer as feedback devices for high-quality chest compression during cardiopulmonary resuscitation. However, to the best of our knowledge, no previous study has reported the effects of this feedback on chest compressions in action. A randomized, parallel controlled study of 40 senior medical students was conducted to examine the effect of chest compression feedback via a smartwatch during cardiopulmonary resuscitation of manikins. A feedback application was developed for the smartwatch, in which visual feedback was provided for chest compression depth and rate. Vibrations from smartwatch were used to indicate the chest compression rate. The participants were randomly allocated to the intervention and control groups, and they performed chest compressions on manikins for 2 min continuously with or without feedback, respectively. The proportion of accurate chest compression depth (≥5 cm and ≤6 cm) was assessed as the primary outcome, and the chest compression depth, chest compression rate, and the proportion of complete chest decompression (≤1 cm of residual leaning) were recorded as secondary outcomes. The proportion of accurate chest compression depth in the intervention group was significantly higher than that in the control group (64.6±7.8% versus 43.1±28.3%; p = 0.02). The mean compression depth and rate and the proportion of complete chest decompressions did not differ significantly between the two groups (all p>0.05). Cardiopulmonary resuscitation-related feedback via a smartwatch could provide assistance with respect to the ideal range of chest compression depth, and this can easily be applied to patients with out-of-hospital arrest by rescuers who wear smartwatches.

Effect of smart devices on the quality of CPR training: A systematic review

“…9,10,[15][16][17][18][19][20][21][22][23] Study characteristics Table 1shows the characteristics of the selected studies. The studies included five RCTs (45%), 9,16,19,22,23 five RCOTs (45%), 10,15,18,20,21 and an RT (9%). 17 Eight of 11 studies (73%) used smartphones 9,10,15-20 and 3 studies (27%) [21][22][23] used smartwatches for their CPR training intervention.…”

“…The studies included five RCTs (45%), 9,16,19,22,23 five RCOTs (45%), 10,15,18,20,21 and an RT (9%). 17 Eight of 11 studies (73%) used smartphones 9,10,15-20 and 3 studies (27%) [21][22][23] used smartwatches for their CPR training intervention. All selected studies were written in English, although the literature search language selection included both English and Korean.…”

“…Five RCTs/RTs (45%) were rated as 'of some concern' since they did not clearly comment on blinding to intervention. 9,16,17,19,22 Five RCOTs were rated as 'high' for this domain either due to insufficient rest time between experimental sessions 10,15,18,20 or due to lack of information on the resting period between experimental sessions. 21 Third, the 'bias due to missing outcome data' was measured.…”

“…All eleven studies (100%) were rated as 'low' for this domain as outcomes were evaluated with the use of manikins designed to measure CPR compression quality in accordance with pre-existing protocols. 9,10,[15][16][17][18][19][20][21][22][23] Fifth, 'bias in section of the reported results' was evaluated. Five RCOTs were rated as 'of some concern' in this domain since there was not enough information on how potential carry-over effects were addressed.…”

“…There have been various studies conducted to show the usefulness of smart devices as CPR feedback devices, but the results have been conflicting thus far. 9,10,[15][16][17][18][19][20][21][22][23] This systematic review aimed to examine randomised trials to determine if smart devices used during CPR training could improve the quality of CPR. Additionally, we investigated what type of smart device, phone or watch, was more effective at improving CPR quality.…”