Improving Cardiopulmonary Resuscitation Quality and Resuscitation Training by Using Real- Time Audiovisual-Assisted Devices

Context Cardiac arrest occurring outside of a medical facility is a significant cause of death and disability worldwide. In developing nations, it accounts for a notable portion of total mortality, with only a small percentage of those affected surviving beyond the initial emergency department intervention. Despite the critical importance of high-quality cardiopulmonary resuscitation (CPR) in these situations, there has been limited research on the effectiveness of audiovisual feedback devices in improving CPR performance among laypersons or non-medical caregivers. These caregivers, often untrained in advanced medical procedures, play a crucial role in the immediate response to cardiac arrest before professional help arrives. This study aims to address this gap by evaluating the impact of such devices on CPR quality delivered by non-medical individuals. Aim This study aimed to determine whether the use of audiovisual devices would improve cardiopulmonary resuscitation performance among non-medical care providers. Materials and methods Using a multiple-choice questionnaire, an audiovisual aid-based prospective observational study (non- interventional observation study) was conducted at a medical college hospital in Kochi from June 2022 to February 2024. A minimum sample size of 66 was derived from pilot studies, with 95% confidence and 90% power. A total of 146 participants met the inclusion criteria (non-medical personnel of 18-50 years of age). After the exclusion of pregnant women and non-interested participants, the study participants were analyzed for the quality of cardiopulmonary resuscitation in a mannequin with the help of audiovisual devices. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 20 (IBM Corp., Armonk, New York, released in 2011). Categorical variables were expressed as frequency and percentage. McNemar's Chi-square test was applied to compare the CPR compression rates with and without the visual feedback device, and the kappa statistic was used to assess how consistently participants performed within the same compression rate category (less than 100, 100-120, or more than 120 compressions per minute) with and without the feedback device. Results The improvement in CPR quality, which was visualized as a green color in the CPR feedback device, was significant, with 109 participants (74.7%) showing good outcomes. The chest compression rate also significantly improved from 95 to 117 with the use of feedback devices (p-0.011, Kappa- 0.167) among nonmedical care providers. While the kappa value suggests that some variability exists in compression rates when switching between with and without feedback, the overall improvement is still noteworthy. Conclusion The majority of participants (74.7%) were able to consistently maintain green light in the visual feedback watch, which means their chest compression rate was within optimal range (100-120/min) when using the audiovisual feedback device. This indicated that use of audiovisual devices significantly improved compression rates among non-medical care providers and effectively helped them perform high-quality CPR.