Prehospital Emergency Care最新文献

{"title":"Prehospital Whole Blood Administration for Pediatric Gastrointestinal Hemorrhage: A Case Report.","authors":"Mathew A Saab, Eric Jacobson, Kip Hanson, Brandon Kruciak, David Miramontes, Stephen Harper","doi":"10.1080/10903127.2024.2372808","DOIUrl":"10.1080/10903127.2024.2372808","url":null,"abstract":"<p><p>The management of gastrointestinal (GI) hemorrhage in a prehospital setting presents significant challenges, particularly in arresting the hemorrhage and initiating resuscitation. This case report introduces a novel instance of prehospital whole blood transfusion to an 8-year-old male with severe lower GI hemorrhage, marking a shift in prehospital pediatric care. The patient, with no previous significant medical history, presented with acute rectal bleeding, severe hypotension (systolic/diastolic blood pressure [BP] 50/30 mmHg), and tachycardia (148 bpm). Early intervention by Emergency Medical Services (EMS), including the administration of 500 mL (16 mL/kg) of whole blood, led to marked improvement in vital signs (BP 97/64 mmHg and heart rate 93 bpm), physiology, and physical appearance, underscoring the potential effectiveness of prehospital whole blood transfusion in pediatric GI hemorrhage. Upon hospital admission, a Meckel's diverticulum was identified as the bleeding source, and it was successfully surgically resected. The patient's recovery was ultimately favorable, highlighting the importance of rapid, prehospital intervention and the potential role of whole blood transfusion in managing acute pediatric GI hemorrhage. This case supports the notion of advancing EMS protocols to include interventions historically reserved for the hospital setting that may significantly impact patient outcomes from the field.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"89-92"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between QRS Characteristics in Pulseless Electrical Activity and Survival Outcome in Cardiac Arrest Patients: A Systematic Review and Meta-Analysis.","authors":"Jae Hwan Kim, Juncheol Lee, Hyungoo Shin, Tae Ho Lim, Bo-Hyoung Jang, Youngsuk Cho, Wonhee Kim, Kyu-Sun Choi, Jae Guk Kim, Chiwon Ahn, Heekyung Lee, Myeong Namgung, Min Kyun Na, Sae Min Kwon","doi":"10.1080/10903127.2024.2360139","DOIUrl":"10.1080/10903127.2024.2360139","url":null,"abstract":"<p><strong>Objective: </strong>Recent studies have shown inconsistent results regarding the association between QRS characteristics and survival outcomes in patients with cardiac arrest and pulseless electrical activity (PEA) rhythms. This meta-analysis aimed to identify the usefulness of QRS width and frequency as prognostic tools for outcomes in patients with cardiac arrest and PEA rhythm.</p><p><strong>Methods: </strong>Extensive searches were conducted using Medline, Embase, and the Cochrane Library to find articles published from database inception to 4 June 2023. Studies that assessed the association between the QRS characteristics of cardiac arrest patients with PEA rhythm and survival outcomes were included. The Newcastle-Ottawa Scale was used to assess the methodological quality of the included studies.</p><p><strong>Results: </strong>A total of 9727 patients from seven observational studies were included in this systematic review and meta-analysis. The wide QRS group (QRS ≥ 120 ms) was associated with significantly higher odds of mortality than the narrow QRS group (QRS < 120 ms) (odds ratio (OR) = 1.86, 95% confidence interval (CI) = 1.11-3.11, <i>I</i>² = 58%). The pooled OR for mortality was significantly higher in patients with a QRS frequency of < 60/min than in those with a QRS frequency of ≥ 60/min (OR = 1.90, 95% CI = 1.19-3.02, <i>I</i>² = 65%).</p><p><strong>Conclusions: </strong>Wide QRS width or low QRS frequency is associated with increased odds of mortality in patients with PEA cardiac arrest. These findings may be beneficial to guide the disposition of cardiac arrest patients with PEA during resuscitation.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"162-169"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest Decompressions - The Driver of CPR Efficacy: Exploring the Relationship Between Compression Rate, Depth, Recoil Velocity, and End-Tidal CO2.","authors":"Kira Chandran, Isabel M Algaze Gonzalez, Sixian Wang, Daniel P Davis","doi":"10.1080/10903127.2024.2364058","DOIUrl":"10.1080/10903127.2024.2364058","url":null,"abstract":"<p><strong>Objective: </strong>Cardiopulmonary arrest survival is dependent on optimization of perfusion <i>via</i> high quality cardiopulmonary resuscitation (CPR), defined by a complex dynamic between rate, depth, and recoil velocity. Here we explore the interaction between these metrics and create a model that explores the impact of these variables on compression efficacy.</p><p><strong>Methods: </strong>This study was performed in a large urban/suburban fire-based emergency medical services (EMS) system over a nine-month period from 2019 to 2020. Manual chest compression parameters [rate/depth/recoil velocity] from a cohort of out-of-hospital cardiac arrest (OOHCA) victims were abstracted from monitor defibrillators (ZOLL X-series) and end-tidal carbon dioxide (ETCO2) from sensors. The mean values of these parameters were modeled against each other using multiple regression and structural equation modeling with ETCO2 as a dependent variable.</p><p><strong>Results: </strong>Data from a total of 335 patients were analyzed. Strong linear relationships were observed between compression depth/recoil velocity (<i>r</i> = .87, <i>p</i> < .001), ETCO2/depth (<i>r</i> = .23, <i>p</i> < .001) and ETCO2/recoil velocity (<i>r</i> = .61, <i>p</i> < .001). Parabolic relationships were observed between rate/depth (<i>r</i> = .39, <i>p</i> < .001), rate/recoil velocity (<i>r</i> = .26, <i>p</i> < .001), and ETCO2/rate (<i>r</i> = .20, <i>p</i> = .003). Rate, depth, and recoil velocity were modeled as independent variables and ETCO2 as a dependent variable with excellence model performance suggesting the primary driver of stroke volume to be recoil velocity rather than compression depth.</p><p><strong>Conclusions: </strong>We used manual CPR metrics from out of hospital cardiac arrests to model the relationship between CPR metrics. These results consistently support the importance of chest recoil on CPR hemodynamics, suggesting that guidelines for optimal CPR should emphasize the importance of maximum chest recoil.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"154-161"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Role of Cognitive Load in Paramedical Contexts: A Systematic Review.","authors":"Jasmine S Zaphir, Karen A Murphy, Alex J MacQuarrie, Matthew J Stainer","doi":"10.1080/10903127.2024.2370491","DOIUrl":"10.1080/10903127.2024.2370491","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive load refers to the working memory resources required during a task. When the load is too high or too low this has implications for an individual's task performance. In the context of paramedicine and emergency medical services (EMS) broadly, high cognitive load could potentially put patient and personnel safety at risk. This systematic review aimed to determine the current understanding of the role of cognitive load in paramedical contexts.</p><p><strong>Methods: </strong>To do this, five databases were searched (Elsevier Embase, ProQuest Psychology, CINAHL, Ovid Medline, and Ovid PsychINFO) using synonyms of cognitive load and paramedical contexts. Included articles were full text, peer reviewed empirical research, with a focus on cognitive load and EMS work. Two reviewers screened titles, abstracts, and full text using a traffic light system against the inclusion and exclusion criteria. The quality of evidence was assessed using the GRADE framework. This study was registered on PROSPERO (CRD42022384246). No funding was received for this research.</p><p><strong>Results: </strong>The searches identified 73 unique articles and after title/abstract and full text screening, 25 articles were included in the final review. Synthesis of the research revealed 10 categories of findings in the area. These are clinical performance, cognitive processes, emotional responses, physical expenditure, physiological responses, equipment and ergonomics, expertise and experience, multiple loads, cognitive load measures, and task complexity.</p><p><strong>Conclusions: </strong>From these findings it was determined that there is agreement in terms of what factors influence cognitive load in paramedical contexts, such as cognitive processes, task complexity, physical expenditure, level of experience, multiple types of loads, and the use of equipment. Cognitive load influences clinical task performance and has a bi-directional relationship with emotion. However, the literature is mixed regarding physiological responses to cognitive load, and how they are best measured. These findings highlight potential intervention points where cognitive load can be managed or reduced to improve working conditions for EMS clinicians and safety for their patients.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"101-114"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Non-ST Segment Elevation Myocardial Infarction Following Intravenous Injection of Sublingual Suboxone.","authors":"Lucas Belmore, Timothy Ahn, Eric Nguyen, Timothy Lenz","doi":"10.1080/10903127.2024.2374999","DOIUrl":"10.1080/10903127.2024.2374999","url":null,"abstract":"<p><p>Non-ST segment elevation myocardial infarction (NSTEMI) is a relatively unknown complication of injecting sublingual Suboxone (buprenorphine/naloxone). Buprenorphine/naloxone should be taken as a sublingual tablet or a buccal film and not injected, so its effects from this mode of administration are not well known. While the differential diagnosis for chest pain is very broad, many practitioners do not associate chest pain with the use of buprenorphine/naloxone. We recommend considering serial electrocardiograms (ECGs) and high-sensitivity troponins for a patient who presents with chest pain after buprenorphine/naloxone use.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"93-95"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Novel Prehospital Clinical Decision Tool and ECG Transmission for STEMI Significantly Reduces Door-to-Balloon Time and Sex-Based Disparities.","authors":"Bryan D Nelson, Conor J McLaughlin, Orlando E Rivera, Kashyap Kaul, Andrew J Ferdock, Zachary M Matuzsan, Ali R Yazdanyar, Jay V Gopal, Ayushi Y Patel, Rachael M Chaska, Bruce A Feldman, Jeanne L Jacoby","doi":"10.1080/10903127.2024.2357595","DOIUrl":"10.1080/10903127.2024.2357595","url":null,"abstract":"<p><strong>Background: </strong>An important method employed to reduce door to balloon time (DTBT) for ST segment elevation Myocardial Infarctions (STEMIs) is a prehospital MI alert. The purpose of this retrospective study was to examine the effects of an educational intervention using a novel decision support method of STEMI notification and prehospital electrocardiogram (ECG) transmission on DTBT.</p><p><strong>Methods: </strong>An ongoing database (April 4, 2000 - present) is maintained to track STEMI alerts. In 2007, an MI alert program began; emergency medicine physicians could activate a \"prehospital MI alert\". In October 2015, modems were purchased for Emergency Medical Services personnel to transmit ECGs. There was concurrent implementation of a decision support tool for identifying STEMI. Sex was assigned as indicated in the medical record. Data were analyzed in two groups: Pre-2016 (PRE) and 2016-2022 (POST).</p><p><strong>Results: </strong>In total, 3,153 patients (1,301 PRE; 1,852 POST) were assessed; the average age was 65.2 years, 32.6% female, 87.7% white with significant differences in age and race between the two cohorts. Of the total 3,153 MI alerts, 239 were false activations, leaving 2,914 for analysis. 2,115 (72.6%) had cardiac catheterization while 16 (6.7%) of the 239 had a cardiac catheterization. There was an overall decrease in DTBT of 27.5% PRE to POST of prehospital ECG transmission (<i>p</i> < 0.001); PRE median time was 74.5 min vs. 55 min POST. There was no significant difference between rates of cardiac catheterization PRE and POST for all patients. After accounting for age, race, and mode of arrival, DTBT was 12.2% longer in women, as compared to men (<i>p</i> < 0.001) PRE vs. POST. DTBT among women was significantly shorter when comparing PRE to POST periods (median 77 min vs. 60 min; <i>p</i> = 0.0001). There was no significant sex difference in the proportion of those with cardiac catheterization between the two cohorts (62.5% vs. 63.5%; <i>p</i> = 0.73).</p><p><strong>Conclusion: </strong>Introduction of a decision support tool with prehospital ECG transmission with prehospital ECG transmission decreased overall DTBT by 20 min (27.5%). Women in the study had a 17-minute decrease in DTBT (22%), but their DTBT remained 12.2% longer than men for reasons that remain unclear.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"170-176"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alfentanil for Pain Relief in a Swedish Emergency Medical Service - An Eleven-Year Follow-up on Safety and Effect.","authors":"Pär Wennberg, Amir Pakpour, Anders Broström, Kåre Karlsson, Carl Magnusson","doi":"10.1080/10903127.2024.2363509","DOIUrl":"10.1080/10903127.2024.2363509","url":null,"abstract":"<p><strong>Objectives: </strong>Pain is a common symptom in prehospital emergency care and pain treatment in this context can be challenging. While previous research has assessed the use of morphine and other synthetic opioids for pain management in this setting, the evaluation of alfentanil is limited. The objective of this study was to evaluate the safety and effect of intravenous alfentanil when administered by ambulance nurses in prehospital emergency care.</p><p><strong>Methods: </strong>This retrospective observational study consecutively included patients suffering from pain, treated with alfentanil in a Swedish EMS service from September 2011 to 31 September 2022. Data regarding occurrence of adverse events (AE), serious adverse events (SAE) - were used for safety evaluation and pain scores with a visual analogue scale (VAS) before and after treatment were used for evaluation of pain treatment. These data were extracted from the electronic patients' medical records database for analysis. Univariate logistic regression analysis was used to identify significant predictors of AE following injection of alfentanil by nurses in prehospital emergency care.</p><p><strong>Results: </strong>During the evaluation period 17,796 patients received pain relief with alfentanil. Adverse events affected 2.5% of the patients, while serious adverse events were identified in 25 cases (0.01%). Out of the 5970 patients with a complete VAS score for pain, the median VAS score was 8 (IQR 3) before treatment and 4 (IQR 3) after treatment. The mean reduction in pain measured by VAS was -4.1 ± 2.6 from the time before, to the evaluation after alfentanil administration. The administration frequency increased during the first year up to a steady level during the later part of the evaluation period.</p><p><strong>Conclusions: </strong>This study proposes that alfentanil represents a safe and efficacious alternative for addressing urgent pain relief within the prehospital emergency context. Alfentanil demonstrates efficacy in alleviating pain across various conditions, with a relatively low risk of adverse events or serious adverse events when administered cautiously.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"188-193"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Efficiency in a Static-Based 9-1-1 Ambulance Service: An Analysis of Operational Performance Metrics.","authors":"Luke E Kayser, Devin E Spolsdoff, J Priyanka Vakkalanka, Talon J Hoefer, Curtis A Walker, Peter K Georgakakos","doi":"10.1080/10903127.2024.2360672","DOIUrl":"10.1080/10903127.2024.2360672","url":null,"abstract":"<p><strong>Objectives: </strong>This study sought to evaluate performance indicators to assist a static-based 9-1-1 agency in defining its response efficiency.</p><p><strong>Methods: </strong>Initial assessment of three metrics-unit hour utilization (UHU), fractile response intervals, and level 0 frequency (occurrence when no ambulances are available to respond)-suggested the agency's response over its four coverage zones was inefficient, so an operational change was implemented: an ambulance was relocated from one service area to another to improve the overall response productivity. A 2-year retrospective analysis was performed to determine the impact ambulance relocation had on the three targeted measurements.</p><p><strong>Results: </strong>The operational change resulted in a statistically significant change in unit hour utilization, a non-significant increase in fractile response intervals, and a statistically significant reduction in level 0 frequency from pre- to post-operational change times.</p><p><strong>Conclusions: </strong>These findings suggest a way to evaluate the efficiency of static-based ambulance deployment and potentially identify strategies for redeployment.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"177-181"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Guided Comparative Analysis of Fatigue Frameworks in Australasian Ambulance Services.","authors":"Matthew J Ferris, Alexander P Wolkow, Kelly-Ann Bowles, Aislinn Lalor","doi":"10.1080/10903127.2024.2381055","DOIUrl":"10.1080/10903127.2024.2381055","url":null,"abstract":"<p><strong>Objective: </strong>Paramedics work in a complex, unpredictable environment, subject to many external stressors including critically unwell patients, dangerous driving conditions, and prolonged shift work. Paramedic fatigue from these and other occupational demands is well documented. Ambulance services attempt to safeguard paramedics from fatigue using internal policies or procedures - a type of Fatigue Risk Management Systems (FRMSs). This study reviews ambulance service fatigue frameworks to understand the current situation in fatigue management in paramedicine, and to identify fatigue monitoring tools, strategies, and other components of these frameworks that are designed to protect personnel.</p><p><strong>Methods: </strong>This study involved a qualitative document thematic content analysis. All eleven statutory ambulance services across Australia, New Zealand, and Papua New Guinea, represented by the Council of Ambulance Authorities, were contacted and invited to participate. Fatigue frameworks were collated and entered into NVivo where data extraction occurred through three a priori areas (fatigue, fatigue mitigation tools & fatigue management).</p><p><strong>Results: </strong>Nine of the eleven ambulance services provided fatigue documentation, with one declining to participate, and one did not respond to invitations. Through thematic analysis and abstraction, seven themes were identified: fatigue definition, consequences of fatigue, sources of fatigue, signs and symptoms of fatigue, fatigue-related incidents, fatigue monitoring tools, and fatigue mitigation. There was also poor alignment between provided frameworks and established FRMSs components.</p><p><strong>Conclusion: </strong>Our findings provide an initial insight into existing ambulance service fatigue frameworks across Australia, New Zealand, and Papua New Guinea. The many inconsistencies in frameworks between ambulance services highlight an opportunity to develop a more consistent, collaborative approach that follows evidence-based FRMSs guidelines.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"120-128"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drone-Facilitated Real-Time Video-Guided Feedback Helps to Improve the Quality of Lay Bystander Basic Life Support. A Randomized Controlled Simulation Trial.","authors":"Calvin Lukas Kienbacher, Wolfgang Schreiber, Harald Herkner, Christoph Holzhacker, Christof C Chwojka, Katharina Tscherny, Alexander Egger, Verena Fuhrmann, Maximilian Niederer, Marco Neymayer, Larissa Bernert, Alexandra Gamsjäger, Isabella Grünbeck, Marietta B Heitger, Line Saleh, Sophie Schmidt, Stephanie Schönecker, Dilara Wirth, Kenneth A Williams, Dominik Roth","doi":"10.1080/10903127.2024.2351970","DOIUrl":"10.1080/10903127.2024.2351970","url":null,"abstract":"<p><strong>Objectives: </strong>Telephone instructions are commonly used to improve cardiopulmonary resuscitation (CPR) by lay bystanders. This usually implies an audio but no visual connection between the provider and the emergency medical telecommunicator. We aimed to investigate whether video-guided feedback via a camera drone enhances the quality of CPR.</p><p><strong>Methods: </strong>We conducted a randomized controlled simulation trial. Lay rescuers performed 8 min of CPR on an objective feedback manikin. Participants were randomized to receive telephone instructions with (intervention group) or without (control group) a drone providing a visual connection with the telecommunicator after a 2-min run-in phase. Performed work (total compression depth minus total lean depth) was the primary outcome. Secondary outcomes were the proportion of effective chest compressions, average compression depth, subjective physical strain measured every 2 min, and dexterity in the nine-hole peg test after the scenario. Outcomes were compared using the <i>t</i>- and Mann Whitney-<i>U</i> tests. A two-sided <i>p</i>-value of <0.05 was considered significant.</p><p><strong>Results: </strong>We included 27 individuals (14 (52%) female, mean age 41 ± 14 years). Performed work was greater in the intervention than in the control group (41.3 ± 7.0 vs. 33.9 ± 10.9 m; absolute difference 7.5, 95% CI 1.4 to 14.8; <i>p</i> = 0.046), with higher average compression depth (49 ± 7 vs. 40 ± 13 mm; <i>p</i> = 0.041), and higher proportions of adequate chest compressions (43 (IQR 14-60) vs. 3 (0-29) %; <i>p</i> = 0.041). We did not find any significant differences regarding the remaining secondary outcomes.</p><p><strong>Conclusion: </strong>Video-guided feedback via drones might be a helpful tool to enhance the quality of telephone-assisted CPR in lay bystanders.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"46-52"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}