Federico Semeraro

iCPR: A new application of high-quality cardiopulmonary resuscitation training☆

OBJECTIVES The present study evaluates a new CPR feedback application for the iPhone (iCPR) designed to improve chest compression performance tested in a cardiac arrest simulation to evaluate performance and acceptance by healthcare professionals and lay people. METHODS We built an application specifically dedicated to self-directed CPR training through a tutorial that includes a simple feedback module to guide training in order to improve the quality of chest compressions. We tested it in a sample of 50 users to evaluate the effect of iCPR on performance and it is acceptance. The participants were randomly assigned to one of the study groups and were asked to perform a trial of 2 min of chest compressions (CC), to answer a predefined set of questions and then to perform two more minutes of CC. The first group performing the sequence of CC with iCPR - questions - CC without feedback, and the second the sequence CC without feedback - questions CC with iCPR. RESULTS The mean compression rate was 101±2.8 min(-1) when CC were performed with iCPR and 107.8±20.5 min(-1) when performed without iCPR (p<0.01). Overall, the participants considered iCPR useful to maintain CC at the desired rate of 100 compressions per minute. CONCLUSIONS The iCPR feedback tool was able to significantly improve the performance of chest compressions in terms of the compression rate in a simulated cardiac arrest scenario. The participants also believed that iCPR helped them to achieve the correct chest compression rate and most users found this device easy to use.

Kids Save Lives – ERC position statement on school children education in CPR.: “Hands that help – Training children is training for life”

Sudden out-of-hospital cardiac arrest (OHCA) with unsuccessful cardiopulmonary resuscitation (CPR) is the third leading cause of death in industrialised nations.1 After OHCA, the overall survival rates are 2–10%.2–4 In Europe and in the US together, 700,000 people die of OHCA every year. The same applies to other industrialised regions of the world. Many of these lives could be saved if more lay people provided immediate CPR.2 Emergency medical services (EMS) response times can be several (6–12) minutes or even longer.

Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality training: A randomised crossover mannequin pilot study

INTRODUCTION Outcome after cardiac arrest is dependent on the quality of chest compressions (CC). A great number of devices have been developed to provide guidance during CPR. The present study evaluates a new CPR feedback system (Mini-VREM: Mini-Virtual Reality Enhanced Mannequin) designed to improve CC during training. METHODS Mini-VREM system consists of a Kinect(®) (Microsoft, Redmond, WA, USA) motion sensing device and specifically developed software to provide audio-visual feedback. Mini-VREM was connected to a commercially available mannequin (Laerdal Medical, Stavanger, Norway). Eighty trainees (healthcare professionals and lay people) volunteered in this randomised crossover pilot study. All subjects performed a 2 min CC trial, 1h pause and a second 2 min CC trial. The first group (FB/NFB, n=40) performed CC with Mini-VREM feedback (FB) followed by CC without feedback (NFB). The second group (NFB/FB, n=40) performed vice versa. Primary endpoints: adequate compression (compression rate between 100 and 120 min(-1) and compression depth between 50 and 60mm); compressions rate within 100-120 min(-1); compressions depth within 50-60mm. RESULTS When compared to the performance without feedback, with Mini-VREM feedback compressions were more adequate (FB 35.78% vs. NFB 7.27%, p<0.001) and more compressions achieved target rate (FB 72.04% vs. 31.42%, p<0.001) and target depth (FB 47.34% vs. 24.87%, p=0.002). The participants perceived the system to be easy to use with effective feedback. CONCLUSIONS The Mini-VREM system was able to improve significantly the CC performance by healthcare professionals and by lay people in a simulated CA scenario, in terms of compression rate and depth.

Virtual reality enhanced mannequin (VREM) that is well received by resuscitation experts

UNLABELLED The objective of this study was to test acceptance of, and interest in, a newly developed prototype of virtual reality enhanced mannequin (VREM) on a sample of congress attendees who volunteered to participate in the evaluation session and to respond to a specifically designed questionnaire. METHODS A commercial Laerdal HeartSim 4000 mannequin was developed to integrate virtual reality (VR) technologies with specially developed virtual reality software to increase the immersive perception of emergency scenarios. To evaluate the acceptance of a virtual reality enhanced mannequin (VREM), we presented it to a sample of 39 possible users. Each evaluation session involved one trainee and two instructors with a standardized procedure and scenario: the operator was invited by the instructor to wear the data-gloves and the head mounted display and was briefly introduced to the scope of the simulation. The instructor helped the operator familiarize himself with the environment. After the patients collapse, the operator was asked to check the patients clinical conditions and start CPR. Finally, the patient started to recover signs of circulation and the evaluation session was concluded. Each participant was then asked to respond to a questionnaire designed to explore the trainees perception in the areas of user-friendliness, realism, and interaction/immersion. RESULTS Overall, the evaluation of the system was very positive, as was the feeling of immersion and realism of the environment and simulation. Overall, 84.6% of the participants judged the virtual reality experience as interesting and believed that its development could be very useful for healthcare training. CONCLUSIONS The prototype of the virtual reality enhanced mannequin was well-liked, without interfence by interaction devices, and deserves full technological development and validation in emergency medical training.

Relive: a serious game to learn how to save lives.

A recent review has provided evidence in support of new nd alternative methods for CPR training.1 Among these, are he “serious games”, which are applications developed using omputer game technologies more often associated with enterainment, but characterized by a serious purpose. Indeed, during he last decade, many serious games have been developed and sed successfully in the field of health, including training of oth technical and non-technical skills relevant to the surgical rea.2 The Italian Resuscitation Council (IRC) has implemented a erious game for the Viva! Campaign 20133 called Viva! Game http://www.viva2013.it/viva-game). Viva! Game is a serious game irected to kids and young adults. It served as a tool to create wareness on cardiac arrest and cardiopulmonary resuscitation CPR) in a soft and enjoyable way. The game has different scenaros, i.e. school, home, stadium, through which the player needs to nteract. More specifically, during the development of the story, he player finds himself in the need to perform a high quality hest compression to save another character from cardiac arrest. iva! CPR (http://www.viva2013.it/vivacpr) is an application for eal time feedback on chest compression quality created for smarthones directed to general population to increase awareness and nowledge about chest compression only manoeuvres. The numer of downloads of Viva! Game and Viva! CPR during the Viva! ampaign 2013 was around 10,000 (Table 1). For the Viva! Camaign 2014, the Italian Resuscitation Council developed a new and ore ambitious project called “Relive” game. Relive is a serious ame focusing on CPR with the main purpose of increasing kids nd young adults’ awareness on CPR and prompting them to attend PR classes and be prepared to intervene in case of cardiac arrest. elive is a first person 3D adventure taking place on planet Mars, n a near future. The game is divided into two different playing odes: a tournament mode and a story mode. The tournament ode is a ready-to-play simulated emergency scene, taken from elected game scenes, where the player faces different rescue sit-

European Resuscitation Council Guidelines for Resuscitation: 2017 update.

As a founding member of the International Liaison Committee n Resuscitation (ILCOR), the European Resuscitation Council (ERC) emains wholeheartedly committed to supporting ILCOR’s mission, ision and values [1]. One of the main functions of ILCOR over the ast 25 years has been to review published research evidence peridically to produce an international Consensus on Science with reatment Recommendations (CoSTR). Since 2000, ILCOR has proided an updated CoSTR every 5 years [2–5] which the ERC has ubsequently incorporated into its guidelines [6–8]. In recent years, he scale and pace of new clinical trials and observational studies n resuscitation science has grown exponentially. This prompted LCOR to review its approach to evidence synthesis and to transiion from a 5-yearly CoSTR to more regular updates, driven by the ublication of new science rather than arbitrary time point anchors.

KIDS SAVE LIVES – Schülerausbildung in Wiederbelebung

© Springer Medizin Verlag GmbH 2017 B. W. Böttiger · F. Semeraro · K.-H. Altemeyer · J. Breckwold · U. Kreimeier · G. Rücker · S. Wingen 1 Klinik für Anästhesiologie und Operative Intensivmedizin, Uniklinik Köln (AöR), Köln, Deutschland Department of Anaesthesia and Intensive Care Medicine, Maggiore Hospital, Bologna, Italien 3 Saarbrücken, Deutschland Dekanat der Medizinischen Fakultät, Universität Zürich, Zürich, Schweiz 5 Klinik für Anaesthesiologie, Klinikum der Universität München, München, Deutschland 6 Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, UniversitätsklinikumRostock, Rostock, Deutschland

Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality improvement.

The most popular method of training in basic life support and AED remains instructor-led training courses. Recent reviews provide good evidence to support alternative methods of training including lay instructors, self-directed learning (web, video, poster) and CPR feedback/prompt devices.

RELIVE: A Markerless Assistant for CPR Training

Cardiopulmonary resuscitation (CPR) is a first-aid key survival technique used to stimulate breathing and keep blood flowing to the heart. Its effective administration can significantly increase the chances of survival in victims of cardiac arrest. In this paper, we propose a markerless system for quality CPR training based on RGB-D (RGB + Depth) sensors, called RELIVE. Then, we report the results of a series of experimental tests conducted to evaluate RELIVE tracking performance. The proposed system is able to accurately track the 3-D position of the hands performing CPR by means of RGB-D sensors to estimate the chest compression rate and depth, providing a real-time visual/audio feedback about the rescuers performance. Finally, the system usability has been assessed by both healthcare professionals and lay people.

RELIVE Tracking for quality cardiopulmonary resuscitation training: An experimental comparison with a standard CPR training mannequin

The most widely used and recognized approach to train high uality basic life support (BLS) manoeuvres and automated exteral defibrillation (AED) remains the classic instructor-led training ourse. A recent review, however, introduced new evidence in upport to alternative methods of training, including the use of selfirected learning and CPR feedback/prompt devices.1 For the Viva! ampaign 2014, the Italian Resuscitation Council developed a new nd more ambitious project called “Relive” game.2 In this article, we ropose a new markerless solution3,4 called RELIVE Tracking still eveloped within the Mini-VREM project,5 which is able to accuately estimate chest compressions depth and rate during chest ompression. In addition, RELIVE Tracking has been tested with two ifferent RGB-D (Red Green Blue-Depth) sensors based on differnt technologies featuring different prizes (Kinect® v1, Microsoft, edmond, WA, USA and Creative Senz3D®, Creative Technology, ingapore, Republic of Singapore) and has been provided of a gameike realistic interface used for conveying a 3D visual feedback to he user/rescuer. The RELIVE Tracking software (the engineer’s heart of Relive ame) was specifically developed, to guide the training and to mprove the quality of chest compression (CC) by tracking the ands of the user, without the need of any marker. RELIVE Trackng features a game-like Graphical User Interface (GUI) (Fig. 1) that llows non-experts to intuitively access all the application. RELIVE racking was tested with both RGB-D sensors, on a sample of ten ealthy subjects to evaluate the effect of the proposed software on C performance. This study was carried out at the PERCRO Laboraory in Pisa in August 2014. Ten male participants were recruited rom students and researchers (non-CPR experts) at the PERCRO aboratory. For each participant, the experiment consisted of a roup of three trials of CC each lasting 30 s and characterized by different depth CC (4–6 cm). Each group of trials was repeated for ach of the two RGB-D sensors, 60 trials in total. For each of the 60 rials, the data were simultaneously acquired with RELIVE Trackng and with a traditional training mannequin (Resusci Anne – RA, aerdal Medical, Stavanger, Norway) that was used for a quantitaive evaluation of the accuracy of CC depth measured with RELIVE racking. The best RELIVE Tracking performance was obtained with ELIVE Tracking using Microsoft Kinect® v1, with an average square uadratic error equal to 4.3 ± 0.3 mm, whereas the worst was with he Creative Senz3d® with a mean square quadratic error equal to .5 ± 0.3 mm. Considering RELIVE Tracking as a low-cost training