Research On The Guidance Process And Verification Of Pre-hospital Cardiopulmonary Resuscitation Based On Telephone And Mobile App

ObjectiveIn view of the contradiction that incidence of out-of-hospital cardiac arrest has been increasing while the public still has a low level of cognition of CPR,this research designed its own T-CPR and smartphone application making reference of two methods: Dispatcher-Assisted Telephone-Cardiopulmonary Resuscitation which is commonly used abroad and the smartphone application-assisted Cardiopulmonary Resuscitation,and conducted the experiment verification: comparing the subjects' CPR implementation under three respective circumstances of non-guidance,T-CPR and smartphone application,and verifying the latter two's functions in the public's conduction of the pre-hospital CPR.This research provides the evidences for the not officially authorized T-CPR designing and the possibility of spreading smartphone application-assisted Cardiopulmonary Resuscitation.MethodologyThe research consists of the following two parts:1.The design and the making of the T-CPR software and the Cardiopulmonary Resuscitation smartphone application.After reading relevant document literature and consulting the experts,the Hands-only T-CPR flow diagram was designed.The flow diagram,focusing on accurate recognition of SCA,correct guidance of CPR gestures and the repetition of high quality CPR key points,was made into Microsoft PowerPoint2010 document and applied to the following experiment verification.The Android smartphone application was designed and made by the same principle.2.The verified experiment under the circumstance of non-guidance,T-CPR and smartphone application.The subjects were divided into non-guidance group,T-CPR group and smartphone application group by random sampling method.Non-guidance group were required to recognize SCA and conduct CPR by listening to the voice that require the them to be a bystander without providing any guidance;T-CPR group were provided with corresponding guidance through the voice;smartphone application group were provided with multi-guidance of text,audio and video.Then the experiment was conducted.The data including the different points in time,the accuracy rate of the gesture and the key parameters of chest compression were collected.The SPSS19 statistic software was used to analyze the data to decide the effect T-CPR and smartphone application have on pre-hospital hands-only CPR.The suggestions as to how to carry out pre-hospital CPR in China were proposed.Result1.Software design and making(1)The PC Microsoft PowerPoint2010 T-CPR software was made,which can provide bystanders with correct rescue procedure and chest compression guidance through audio.(2)The CPR Android smartphone application was made,which can provide bystanders with correct rescue procedure and chest compression guidance through text,video and audio.2.Experiment verification(1)91 subjects were tested,among which 30 of them were in non-guidance group,34 of them were in T-CPR group and 27 of them were in smartphone application group.There were another three subjects who couldn't finish the task,two were due to equipment failure and one was due to subject's uncooperation.(2)Outcome after analyzing the different points in time: as for the time the subjects needed to recognize SCA,there was a negative correlation between the T-CPR group and the smartphone application group,but both of their time was longer than the non-guidance group's and the difference was statistically significant.As for the time the subjects needed from recognizing the SCA to conducting the first chest compression,there was a negative correlation between the non-guidance group and the smartphone application group,but both of them needed less time than the T-CPR group,and the difference was statistically significant.(3)Outcome after analyzing the accuracy rate of the gesture: as for the accuracy rate of recognizing the SCA method,there was a negative correlation between the T-CPR group and the smartphone application group,and both of them are superior to the non-guidance group and the difference was statistically significant.(4)Outcome after analyzing the key parameters of the chest compressions: as for the hands-off time,mean of no flow time,mean rate of all compressions during one session,mean compressions depth,there was no statistically significant difference between the T-CPR group and the smartphone application group,but both the groups are superior to non-guidance group,and the differences were statistically significant except for the no-guidance group and T-CPR group in terms of mean rate of all compression.As for the compression with correct hand position and compressions fully released rate,there was no positive correlation among the three groups.Conclusion1.Priority should be given to the pre-hospital CPR guidance.Since the CPR training hasn't been widespread in China at present,the public has a misunderstanding and bias on CPR and their capability of doing CPR is deficient,instructing the public through telephone or smartphone can increase the SCA recognition rate and improve their chest compression gesture and the key indicators such as compression frequency and depth,thus can lead to an improved CPR effect and pre-hospital rescue success rate.2.It's necessary to spread the CPR smartphone application.Both T-CPR and CPR smartphone application can improve bystanders' performance to do CPR.CPR smartphone application is superior to T-CPR in the first time of chest compressions and some parts of the compression gestures after recognizing SCA.Instructions can be provided to those who want to conduct chest compression through installing a CPR application to their smartphones,thus the public doesn't have to stand in the dilemma of its willingness to perform CPR and lack of legal support,which will increase the occurring rate of patient of OHCA.Therefore,at the present stage,before the authorized rules and laws and T-CPR protocol,it's necessary to spread CPR smartphone application among the public.