Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial

Article Article scientifique Article Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial eng 2017 author Siebert Johan 0000-0002-2871-3382 507348 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Ehrler Frédéric 509959 author Gervaix Alain 31715 author Haddad Kevin author Lacroix Laurence Elisabeth 84201 author Schrurs Philippe 754083 author Sahin Ayhan 724163 author Lovis Christian 0000-0002-2681-8076 29016 author Manzano Sergio 0000-0001-9603-5520 88371 e183 10.2196/jmir.7379 28554878 1438-8871 PMC5468544 https://www.jmir.org/2017/5/e183/ Background: The American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) are nowadays recognized as the world's most authoritative resuscitation guidelines. Adherence to these guidelines optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite their availability, suboptimal quality of CPR is still common. Currently, the median hospital survival rate after pediatric in-hospital cardiac arrest is 36%, whereas it falls below 10% for out-of-hospital cardiac arrest. Among emerging information technologies and devices able to support caregivers during resuscitation and increase adherence to AHA guidelines, augmented reality (AR) glasses have not yet been assessed. In order to assess their potential, we adapted AHA Pediatric Advanced Life Support (PALS) guidelines for AR glasses. Objective: The study aimed to determine whether adapting AHA guidelines for AR glasses increased adherence by reducing deviation and time to initiation of critical life-saving maneuvers during pediatric CPR when compared with the use of PALS pocket reference cards. Methods: We conducted a randomized controlled trial with two parallel groups of voluntary pediatric residents, comparing AR glasses to PALS pocket reference cards during a simulation-based pediatric cardiac arrest scenario-pulseless ventricular tachycardia (pVT). The primary outcome was the elapsed time in seconds in each allocation group, from onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, as well as the time intervals between defibrillation attempts and drug doses, shock doses, and number of shocks. All these outcomes were assessed for deviation from AHA guidelines. Results: Twenty residents were randomized into 2 groups. Time to first defibrillation attempt (mean: 146 s) and adherence to AHA guidelines in terms of time to other critical resuscitation endpoints and drug dose delivery were not improved using AR glasses. However, errors and deviations were significantly reduced in terms of defibrillation doses when compared with the use of the PALS pocket reference cards. In a total of 40 defibrillation attempts, residents not wearing AR glasses used wrong doses in 65% (26/40) of cases, including 21 shock overdoses >100 J, for a cumulative defibrillation dose of 18.7 Joules per kg. These errors were reduced by 53% (21/40, P<.001) and cumulative defibrillation dose by 37% (5.14/14, P=.001) with AR glasses. Conclusions: AR glasses did not decrease time to first defibrillation attempt and other critical resuscitation endpoints when compared with PALS pocket cards. However, they improved adherence and performance among residents in terms of administering the defibrillation doses set by AHA. Biomedical technologies Emergency medicine Equipment and supplies Eyeglasses Pediatrics Resuscitation Cardiopulmonary Resuscitation / methods Cardiopulmonary Resuscitation / standards Child Female Guideline Adherence Hospitals, Pediatric / standards Humans Male Prospective Studies Dewey 616.0757 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 62 Département de radiologie et informatique médicale 227 false 149 Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile 183 344 Interfaces Homme-machine en milieu clinique 610 Journal of Medical Internet Research 19 5 dd6be0ea-7854-4fcd-a749-6036a9521030 Article (Published version) Public fc-xsltGalley-7379-128596-36-PB.pdf 1391363 application/pdf CC BY-2.0 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

Title	Published in	Year	Views	Downloads

Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial	Journal of Medical Internet Research	2017	779	611
Adapting Guidelines for Google Glass: the Case of Pediatric CPR	Studies in health technology and informatics	2016	805	0

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Schrurs, Philippe