Effect of a smartphone application on dispatcher-assisted CPR and AED response in simulated out-of-hospital cardiac arrest

Abstract

Objective Early bystander cardiopulmonary resuscitation (CPR) and rapid automated external defibrillator (AED) use are key determinants of survival following out-of-hospital cardiac arrest (OHCA). Smartphone applications may enhance dispatcher-assisted CPR (DA-CPR) and facilitate early AED access; however, evidence regarding their effectiveness in standardized simulation settings remains limited. This study evaluated the effectiveness of a smartphone application for DA-CPR and AED response during simulated OHCA. Methods This randomized simulation-based study was conducted using standardized OHCA scenarios in a controlled simulation environment. Fifty emergency medical dispatch personnel and 190 trained lay responders were randomly assigned to either a smartphone application group or a standard practice group. Primary outcomes were time to CPR initiation and time to first AED shock. Secondary outcomes included time to OHCA recognition, time to scenario completion, and high-quality CPR performance. Outcomes were compared using independent t-tests or Welch’s t-tests, as appropriate. Results Among dispatchers (n = 50), smartphone application use was associated with a shorter time to CPR initiation than the control condition (mean difference [MD], −0.56 min; 95% confidence interval [CI], −1.05 to −0.07; p = 0.026). Among lay responders (n = 190), application use was associated with shorter times to OHCA recognition (MD, −0.13 min; 95% CI, −0.21 to −0.05; p = 0.001) and scenario completion (MD, −0.24 min; 95% CI, −0.42 to −0.06; p = 0.011), but a longer time to CPR initiation (MD, 0.24 min; 95% CI, 0.01–0.47; p = 0.038). No statistically significant between-group differences were observed in the time to first AED shock or overall high-quality CPR performance. Conclusion In standardized simulated OHCA scenarios, use of the MySOS app was associated with a shorter time to first compression among dispatchers but a longer time to first compression among laypersons. No significant association was observed between MySOS use and time to first shock.