Real-Time Chest Compression Quality Measurements by Smartphone Camera

Abstract

Out-of-hospital cardiac arrest (OHCA) is recognized as a global mortality challenge, and digital strategies could contribute to increase the chance of survival. In this paper, we investigate if cardiopulmonary resuscitation (CPR) quality measurement using smartphone video analysis in real-time is feasible for a range of conditions. With the use of a web-connected smartphone application which utilizes the smartphone camera, we detect inactivity and chest compressions and measure chest compression rate with real-time feedback to both the caller who performs chest compressions and over the web to the dispatcher who coaches the caller on chest compressions. The application estimates compression rate with 0.5 s update interval, time to first stable compression rate (TFSCR), active compression time (TC), hands-off time (TWC), average compression rate (ACR), and total number of compressions (NC). Four experiments were performed to test the accuracy of the calculated chest compression rate under different conditions, and a fifth experiment was done to test the accuracy of the CPR summary parameters TFSCR, TC, TWC, ACR, and NC. Average compression rate detection error was 2.7 compressions per minute (±5.0 cpm), the calculated chest compression rate was within ±10 cpm in 98% (±5.5) of the time, and the average error of the summary CPR parameters was 4.5% (±3.6). The results show that real-time chest compression quality measurement by smartphone camera in simulated cardiac arrest is feasible under the conditions tested.

Dispatcher-assisted cardiopulmonary resuscitation for paediatric out-of-hospital cardiac arrest: A structured evaluation of communication issues using the SACCIA® safe communication typology

“…We recommend that DACPR training for dispatchers should focus on appropriate repetition (e.g., engaging callers to actively count their compressions out loud). The training could also focus on the directness of the channel (using multiple functions of the smart phone to facilitate DACPR communication, e.g., video call, 34 GPS location, or specific app's 35,36 ) and situation-specific script adherence (e.g., using computer prompts to emphasize important language specific details of the script). Other recommendations include the use of simulation to validate the translation of the DACPR script into different languages, and the use of a metronome to guide the dispatcher on correct compression rates.…”

Telehealth in emergency medicine: A consensus conference to map the intersection of telehealth and emergency medicine

“…Smartphones with the addition of software can be used for physical examination, information communication (e.g., ECGs), performance feedback (e.g., CPR), and consultation (e.g., orthopedic injuries). [190][191][192][193][194][195][196][197][198][199] While promising, these studies lacked follow-up to demonstrate safety with wider implementation. [200][201][202][203][204] Several studies evaluated the quality of patient-reported data (e.g., blood pressure) and concluded that these were reliable means to collect such data.…”

Effect of a real-time feedback smartphone application (TCPRLink) on the quality of telephone-assisted CPR performed by trained laypeople in China: a manikin-based randomised controlled study

“…The accuracy and validation of the TCPRLink app has been demonstrated earlier. 17 The illustration of the application in use is presented in figure 1. By clicking the 'Press to start TCPR Link' button, the application activates the speaker, establishes a telephone connection with the dispatcher, activates the TCPRLink app which captures and analyses the CPR movement via the front facing camera of the smartphone in real time, and simultaneously sends the location and real-time compression data to a web server which is available for the dispatcher (web server: http:// tcprlink.…”

“… 13 14 In adherence to these guidelines, an audiovisual smartphone application (TCPRLink) was developed to facilitate high-quality bystander-provided CPR and assist the dispatcher to evaluate the CPR quality in real time. 15 The TCPRLink application utilises the smartphone front camera to detect chest compressions (CC) and displays the CC rate to the bystanders and simultaneously sends the real-time CC rate and the time without compressions via the internet to a monitor that is in front of the dispatcher.…”