AR-CPR: Refinement and Large-Scale Simulation-Based Testing of a Novel Augmented Reality Point of Care Chest Compression Feedback System
The augmented reality cardiopulmonary resuscitation headset has the potential to improve the quality of pediatric chest compressions, save lives, and improve care equity in lower-resource settings.
Project Details -
Ongoing
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Grant NumberR21 HS029372
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AHRQ Funded Amount$1,025,000
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Principal Investigator(s)
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Organization
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LocationBaltimoreMaryland
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Project Dates04/01/2023 - 03/31/2028
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Technology
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Care Setting
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Medical Condition
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Type of Care
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Health Care Theme
In the United States, about 20,000 children experience cardiac arrests each year, with less than half surviving. Under-resourced hospitals are often unable to afford to provide ongoing Pediatric Advanced Life Support (PALS) training for their staff, resulting in staff being under-trained in cardiopulmonary resuscitation (CPR). Causes of insufficient pediatric compression quality include variation in size and chest wall compliance and the emotional stress of a dying child. Rates of high-quality chest compressions improve by 32 percent when a quality CPR (qCPR) coach, such as a teammate giving real-time feedback, is present. While effective, qCPR coaching is resource intensive, limiting both its use and the quality of care in settings with untrained staff.
In previous research, the study team developed an augmented reality (AR) system called AR-CPR. This system provides visual feedback in the provider’s field of view using a headset device, allowing real-time improvement of chest compression quality. AR-CPR shows promising usability and feasibility in a simulation-based setting, with the system raising pediatric guideline-compliant CPR by providers from 17 percent to 73 percent. In this current study, researchers will refine the tool to improve pediatric chest compression quality in a simulated setting.
The specific aims of the research are as follows:
- Refine AR-CPR for accuracy and precision of rate and depth, enhance usability, and add recoil sensors.
- Test AR-CPR in a large-scale high fidelity simulated setting.
- Quantitatively evaluate AR-CPR in a multicenter randomized study.
- Qualitatively evaluate usability and user experience.
Engineers will enhance AR-CPR rate and depth sensors using an upgraded inertial measurement unit to measure chest compressions accurately in real-time. They will also create direct wireless communication between the sensors and the AR-CPR display, allowing for an always-on system capable of instantaneous use. Lastly, they will develop chest recoil detection through real-time data analysis of the upgraded system, adding this key component of CPR feedback.
Researchers will then evaluate the tool by comparing the rate of high-quality compressions over 1-minute intervals while using AR-CPR, to compressions performed while using qCPR coaches. This randomized control study will be in collaboration with the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE), and take place at eight sites across the United States and Canada. Researchers hypothesize that AR-CPR will be as effective as qCPR coaches at providing chest compression feedback during a simulated pediatric cardiac arrest. They also believe that tool enhancements will improve adherence to PALS guidelines and the rate of high-quality CPR performance.
AR-CPR has the potential for saving lives and improving care equity in lower-resource settings. The tool has a lower cost and fewer personnel utilization and training needs than qCPR coaching, allowing enhanced scalability across many clinical sites. The study team anticipates delivering a portable, easy to use, accurate, and affordable system that can support providers performing pediatric CPR at the point of care. Additionally, the team believes there is an opportunity to update and scale the coaching software in support of Adult Cardiac Life Support guidelines.