JMIR Publications

ABSTRACT

Background:

Effective and timely delivery of cardiac arrest interventions during in-hospital cardiac arrest (IHCA) resuscitation is associated with greater survival. Whether a mobile application that provides timely reminders of critical interventions improves adherence to Advanced Cardiovascular Life Support (ACLS) guidelines among house officers remains unknown

Objective:

To assess the impact of a dynamic mobile application on house officer adherence to ACLS guidelines

Methods:

As part of a quality improvement initiative, internal medicine house officers were randomized to lead one cardiac arrest simulation with a novel mobile application and one without. All simulations included 4 rhythm cycles and were video recorded. The co-primary endpoints were chest compression fraction and number of correct interventions in each simulation. The secondary endpoint was incorrect interventions, defined as interventions not indicated by the 2015 ACLS guidelines. Paired t-tests compared performance with and without the mobile application.

Results:

Among 53 house-officers 26 were randomized to do the first simulation with the mobile application and 27 without the application. Use of the mobile application was associated with a higher number of correct ACLS interventions (out of 7): mean of 6.2 vs. 5.1; absolute difference of 1.1 (95% CI: 0.6, 1.6; P<0.001) as well as fewer incorrect ACLS interventions (mean of 0.3 vs. 1.0; absolute difference of -0.7 (95% CI: -0.3, -1.0; P<0.001). Simulations with the mobile application also had a marginally higher chest compression fraction (mean: 90.9% vs. 89.0%; absolute difference 1.9% (95% CI: 0.6%, 3.4%; P=0.007).

Conclusions:

This proof-of-concept study suggests this novel mobile application may improve adherence to ACLS protocols, but its effect on survival in real-world resuscitations remains unknown.