Prehosp Emerg Care. 2025 Aug 20:1-16. doi: 10.1080/10903127.2025.2547651. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate video-assisted dispatcher cardiopulmonary resuscitation (CPR) versus audio-assisted dispatcher CPR effects on compression quality in simulated out-of-hospital cardiac arrest (OHCA) scenarios.
METHODS: Network meta-analysis of randomized controlled trials (RCTs) comparing video-assisted dispatcher CPR (V-DACPR) versus audio-assisted dispatcher CPR (A-DACPR) and control. Primary outcome was compression rate; secondary outcomes included compression depth, time to first compression, and interruption time. Network meta-analysis of randomized controlled trials comparing dispatcher-guided CPR with video feedback versus telephone-only instructions in simulated out-of-hospital cardiac arrest scenarios using high-fidelity manikins. Three intervention arms were compared: video-assisted CPR, audio-assisted CPR, and unguided CPR (control). Standardized mean differences (SMD) and Surface Under the Cumulative Ranking curve (SUCRA) were calculated using Bayesian network meta-analysis methodology. Primary outcome was compression rate; secondary outcomes included compression depth, time to first compression, and interruption time.
RESULTS: Fifteen trials (n = 1,556) were analyzed. V-DACPR showed superior compression rates versus A-DACPR (effect size: -21.37, 95% CI: -36.10, -7.41) and control (-43.04, 95% CI: -63.05, -22.52). V-DACPR demonstrated better time to first compression versus control (-42.23, 95% CI: -83.31, -1.42) and favorable trends in compression depth (-5.06, 95% CI: -12.40 to 2.12) and interruption time, though several comparisons between V-DACPR and A-DACPR did not reach statistical significance. Heterogeneity was low to moderate (I2=12-63%). CINeMA assessment supported moderate to high-quality evidence.
CONCLUSIONS: Video-assisted dispatcher cardiopulmonary resuscitation (CPR) demonstrated significant advantages in compression rate in simulated scenarios, with favorable trends in other quality metrics compared to A-DACPR. These findings support the potential for video assistance technology in dispatcher-guided CPR, particularly for optimizing compression rates. However, these results were observed in simulation studies and require validation in real-world clinical settings to determine their impact on patient outcomes.
PMID:40834332 | DOI:10.1080/10903127.2025.2547651
