Annals of Emergency Medicine
Volume 55, Issue 6 , Pages 538-543.e1, June 2010

Cell Phone Cardiopulmonary Resuscitation: Audio Instructions When Needed by Lay Rescuers: A Randomized, Controlled Trial

  • Raina M. Merchant, MD, MS

      Affiliations

    • Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania School of Medicine, Philadelphia, PA
    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
    • Corresponding Author InformationAddress for correspondence: Raina M. Merchant, MD, MS, University of Pennsylvania, 13th Floor Blockley Hall, 423 Guardian Street, Philadelphia, PA 19104; 215-573-2616, fax 215-573-2742
  • ,
  • Benjamin S. Abella, MD, MPhil

      Affiliations

    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • Edem J. Abotsi, BA

      Affiliations

    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • Thomas M. Smith, RN

      Affiliations

    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • Judith A. Long, MD

      Affiliations

    • Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
  • ,
  • Martha E. Trudeau, RN, MPA

      Affiliations

    • Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
  • ,
  • Marion Leary, RN

      Affiliations

    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • Peter W. Groeneveld, MD, MS

      Affiliations

    • Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
  • ,
  • Lance B. Becker, MD

      Affiliations

    • Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • David A. Asch, MD, MBA

      Affiliations

    • Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA

Received 28 August 2009; received in revised form 11 October 2009 and 18 December 2009; accepted 13 January 2010. published online 08 March 2010.

Study objective

Given the ubiquitous presence of cellular telephones, we seek to evaluate the extent to which prerecorded audio cardiopulmonary resuscitation (CPR) instructions delivered by a cell telephone will improve the quality of CPR provided by untrained and trained lay rescuers.

Methods

We randomly assigned both previously CPR trained and untrained volunteers to perform CPR on a manikin for 3 minutes with or without audio assistance from a cell telephone programmed to provide CPR instructions. We measured CPR quality metrics—pauses (ie, no flow time), compression rate (minute), depth (millimeters), and hand placement (percentage correct)—across the 4 groups defined by being either CPR trained or untrained and receiving or not receiving cell telephone CPR instructions.

Results

There was no difference in CPR measures for participants who had or had not received previous CPR training. Participants using the cell telephone aid performed better compression rate (100/minute [95% confidence interval (CI) 97 to 103/minute] versus 44/minute [95% CI 38 to 50/minute]), compression depth (41 mm [95% CI 38 to 44 mm] versus 31 mm [95% CI 28 to 34 mm]), hand placement (97% [95% CI 94% to 100%] versus 75% [95% CI 68% to 83%] correct), and fewer pauses (74 seconds [95% CI 72 to 76 seconds] versus 89 seconds [95% CI 80 to 98 seconds]) compared with participants without the cell telephone aid.

Conclusion

A simple audio program that can be made available for cell telephones increases the quality of bystander CPR in a manikin simulation.

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 Supervising editor: Robert A. De Lorenzo, MD, MSM

 Author contributions: RMM, LBB, and DAA conceived and designed the study. RMM and DAA obtained research funding. RMM, BSA, and DAA supervised the conduct of the study and data collection. RMM, EJA, and TMS undertook recruitment of the patients and managed data, including quality control. RMM, JAL, PWG, and DAA provided statistical advice on study design. RMM, BSA, EJA, TMS, LBB, and DAA analyzed the data. RMM drafted the article and all authors contributed substantially to its revision. RMM takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This research was supported by funding from the Philadelphia Veterans Affairs Medical Center for Health Equity Research and Promotion pilot grant and the Robert Wood Johnson Foundation Clinical Scholars program at the University of Pennsylvania. The contents do not reflect the views of the Department of Veterans Affairs or the United States Government.

 Please see page 539 for the Editor's Capsule Summary of this article.

 Reprints not available from the authors.

 Publication date: Available online March 4, 2010.

PII: S0196-0644(10)00043-0

doi:10.1016/j.annemergmed.2010.01.020

Annals of Emergency Medicine
Volume 55, Issue 6 , Pages 538-543.e1, June 2010