Using a smartwatch with real-time feedback improves the delivery of high-quality cardiopulmonary resuscitation by healthcare professionals

Aim: Cardiopulmonary resuscitation (CPR) quality affects survival after cardiac arrest. We aimed to investigate if a smartwatch with real-time feedback can improve CPR quality by healthcare professionals.

Methods: An app providing real-time audiovisual feedback was developed for a smartwatch. Emergency Department (ED) professionals were recruited and randomly allocated to either the intervention group wearing a smartwatch with the preinstalled app, or to a control group. All participants were asked to perform a two-minute CPR on a manikin at a 30:2 compression-ventilation ratio. Primary outcomes were the mean CCR and CCD measured on the manikin. A secondary outcome was the percentage of chest compressions meeting both the guideline-recommended rate (100-120 min^-1) and depth (50-60 mm) of high-quality CPR during a 2-min period. Differences between groups were evaluated with t-test, Chi-Square test, or Mann-Whitney U test depending on the distribution.

Results: Eighty participants were recruited. 40 people were assigned to the intervention and 40 to the control group. The compression rates (mean ± SD, min^-1) were significantly faster (but above the guideline recommendation, P < 0.001) in the control (129.1 ± 14.9) than in the intervention group (112.0 ± 3.5). The compression depths (mean ± SD, mm) were significantly deeper (P < 0.001) in the intervention (50.9 ± 6.6) than in the control group (39.0 ± 8.7). The percentage (%) of high-quality CPR was significantly higher (P < 0.001) in the intervention (median 39.4, IQR 27.1-50.1) than in the control group (median 0.0, IQR 0.0-0.0).

Conclusion: Without real-time feedback, chest compressions tend to be too fast and too shallow. CPR quality can be improved with the assistance of a smartwatch providing real-time feedback.