• Hannes Ecker, Falko Lindacher, Niels Adams, Stefanie Hamacher, Sabine Wingen, Robert Schier, Bernd W Böttiger, and Wolfgang A Wetsch.
• From the University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine (HE, FL, NA, SW, RS, BWB, WAW); University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology (IMSB), Cologne, (SH) Germany.
• Eur J Anaesthesiol. 2020 Apr 1; 37 (4): 294-302.

BackgroundDespite intensive research, cardiac arrest remains a leading cause of death. It is of paramount importance to undertake every possible effort to increase the overall quality of cardiopulmonary resuscitation (CPR) and improve patient outcome. CPR initiated by a bystander is one of the key factors in survival of such an incident. Telephone-assisted CPR (T-CPR) has proved to be an effective measure in improving layperson resuscitation.ObjectiveWe hypothesised that adding video-telephony to the emergency call (video-CPR, V-CPR) enhances the quality of layperson resuscitation.DesignThis randomised controlled simulation trial was performed from July to August 2018. Laypersons were randomly assigned to video-assisted (V-CPR), telephone-assisted (T-CPR) or control (unassisted CPR) groups. Participants were instructed to perform first aid on a mannequin during a simulated cardiac arrest.SettingThis study was conducted in the Skills Lab of the University Hospital of Cologne.ParticipantsOne hundred and fifty healthy adult volunteers.InterventionThe participants received a smartphone to call emergency services, with Emergency Eye video-call in V-CPR group, and normal telephone functionality in the other groups. T-CPR and V-CPR groups received standardised CPR assistance via phone.Main Outcome MeasuresOur primary endpoint was resuscitation quality, quantified by compression frequency and depth, and correct hand position.ResultsMean compression frequency of V-CPR group was 106.4 ± 11.7 min, T-CPR group 98.9 ± 12.3 min (NS), unassisted group 71.6 ± 32.3 min (P < 0.001). Mean compression depth was 55.4 ± 12.3 mm in V-CPR, 52.1 ± 13.3 mm in T-CPR (P < 0.001) and 52.9 ± 15.5 mm in unassisted (P < 0.001). Total percentage of correct chest compressions was significantly higher (P < 0.001) in V-CPR (82.6%), than T-CPR (75.4%) and unassisted (77.3%) groups.ConclusionV-CPR was shown to be superior to unassisted CPR, and was comparable to T-CPR. However, V-CPR leads to a significantly better hand position compared with the other study groups. V-CPR assistance resulted in volunteers performing chest compressions with more accurate compression depth. Despite reaching statistical significance, this may be of little clinical relevance.Trial RegistrationClinicalTrials.gov (Identifier: NCT03527771).

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