Can Mobile Videocall Assist Laypersons’ Use of Automated External Defibrillators? A Randomized Simulation Study and Qualitative Analysis

Abstract

Background and Importance. The rate of bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) has increased rapidly in the past 10 years. However, laypersons’ use of automated external defibrillator (AED) is still low in comparison with bystander CPR. Objective. To investigate the feasibility of mobile videocall guidance to facilitate AED use by laypersons. Design, setting, and participants. A total of 90 laypersons were randomized into three groups: the mobile video call-guided, voice call-guided, and non-guided groups. Participants were exposed to simulated cardiac arrest to use an AED, and guided by video calls, voice calls, or were not guided. We recorded the simulation experiments as a videoclip, and other researchers who were blinded to the simulation assessed the performance according to the prespecified checklist after simulations. Outcomes measure and analysis. We compared the performance score and time intervals from AED arrival to defibrillation among the three groups and analyzed the common errors. Results. There was no significant difference among the three groups in terms of baseline characteristics. Performance scores in the checklist for using AED were higher in the mobile video call-guided group, especially in the category of “Power on AED” and “Correctly attaches pads” than in the other groups. However, the time interval to defibrillation was significantly longer in the mobile video call-guided group. Conclusions. Mobile video call guidance might be an alternative method to facilitate AED use by laypersons. Therefore, further well-designed research is needed to evaluate the feasibility of this approach in OHCA.