A Smartphone application to provide real-time cardiopulmonary resuscitation quality feedback

Background: Quality of cardiopulmonary resuscitation (CPR) contributes significantly to outcomes. Key determi-nants of CPR quality pertaining to chest compressions are compression rate, compression depth, duration of in-terruptions, and chest recoil. Several studies have demonstrated that real-time audiovisual feedback improves CPR quality. We hypothesize that a mobile application using sensor data from built-in accelerometers in smartphones can provide accurate chest compression quality feedback in real time. This study aims to develop and validate an application for smartphone which can provide real-time audiovisual and haptic feedback on determinants of CPR quality. Methods: A mobile application was developed to detect the compression depth and compression rate in real time using data captured from a smartphone's intrinsic accelerometer. The mobile device was placed on an adult manikin's chest at the point of compressions. In a simulated environment, data obtained using the application was compared directly to data obtained from a validated standard CPR quality tool. Results: CPR quality parameters were obtained from the application and industry standard for 60, 30s-long sessions. Bland-Altman plot analysis for compression depth showed agreement between the app measurements and standard within +/- 4 mm (<10% error). The interclass correlation for agreement in the measurement of compression count was 0.92 (95% CI: 0.88-0.95), indicative of very strong agreement. Conclusions: Smart device applications using acceleration sensor data derived from smart phones can accurately provide real-time CPR quality feedback. With further development and validation, they can provide a ubiqui-tously available CPR feedback tool valuable for out-of-hospital arrests and in-hospital arrests in under-privileged areas. (C) 2022 Elsevier Inc. All rights reserved.