JMIR Publications

ABSTRACT

Background:

In life-threatening emergencies, early action by bystanders is particularly important for the survival of victims, especially in case of cardiac arrest or airway obstruction. It is currently recommended that bystanders be encouraged to perform first-aid in all situations where it is required. However, few bystanders are willing to perform cardiopulmonary resuscitation (CPR). The main reasons are for this are the fear of not knowing how to perform CPR, coupled with the reluctance of dispatchers to rely on bystanders who are by default considered "untrustworthy". The use of live video during emergency calls appears to have a positive effect on the confidence of bystanders to provide CPR themselves, and on the confidence of dispatchers in them.

Objective:

The objective is to propose and evaluate the relevance of a Living Lab methodology for simulated life-threatening emergency call situations, when live video tools are introduced in the call sequence.

Methods:

The first exploratory phase aimed at analysing the process of dealing with out-of-hospital cardiac arrest (OHCA) situations in an emergency medical communication centre (EMCC) and at collecting the needs of the dispatchers. In the second phase, we pre-test the Living Lab.. This consisted of simulating five OHCA situations, while transmitting a live CPR demonstration video. The aim was to identify and analyse the benefits and constraints of using live video demonstration. The third phase is the Living Lab, in which 16 situations of cardiac arrest and airway obstruction will be simulated. The simulation will include both a live video link between the dispatcher and those present and the live transmission of a video demonstration of emergency procedures. The measures will focus on three areas: the place of live video tools (practitioner axis) and the impact of these on the quality of first aid actions performed by witnesses, the establishment of trust and collaboration within the community, and the interest of developing a Living Lab through an iterative method.

Results:

The first results concerning the practitioner axis show that dispatchers have an interest in visualising the scene with live video, and also in broadcasting a live demonstration video when possible. Initial results also show that trust and collaboration within the community are enhanced by the shared simulation and debriefing experiences, clarifying regulation procedures and improving communication. Finally, an iterative development, based on the learnings, expectations and constraints of each previous phase, seems to bring a lot of precision for the realization of a Living Lab aiming at determining the place of live video tools in the sequence of care performed by the dispatchers.

Conclusions:

The Living Lab methodology, as described here, seems to be a powerful tool to determine the place of the use of digital tools within an emergency telephone assistance sequence.