This study evaluates whether an augmented reality cardiopulmonary resuscitation feedback system (AR-CPR) can support health care providers in delivering high-quality chest compressions during pediatric cardiac arrest. AR-CPR provides real-time visual feedback on chest compression rate, depth, and recoil through a head-mounted augmented reality display.
In this randomized, multicenter, international, simulation-based non-inferiority study, health care providers perform chest compressions during an 18-minute simulated pediatric cardiac arrest. Participants are assigned to receive either real-time feedback from AR-CPR or coaching from a trained human CPR coach. The primary objective is to determine whether the percentage of chest compressions meeting guideline targets for both rate and depth with AR-CPR is non-inferior to that achieved with human CPR coaching.
Actively credentialed pediatric emergency department or pediatric intensive care unit nurse or clinical technician at a participating study site
Current American Heart Association (AHA) Pediatric Advanced Life Support (PALS) certification
Inability to physically perform chest compressions
Need for prescription corrective lenses without having those corrective lenses available at the time of study participation
Parallel
AR-CPR
DeviceAR-CPR is a real-time augmented reality CPR feedback system designed to guide chest compression performance during pediatric cardiac arrest. The system uses a compression sensor containing an inertial measurement unit (IMU) and force-sensitive resistor (FSR) connected to a microcontroller. Sensor data are relayed to a Raspberry Pi 5 microcomputer running custom AR-CPR Coach software, which calculates chest compression rate, depth, and recoil. These metrics are transmitted wirelessly to a Vuzix M400 head-mounted display. The augmented reality interface provides numerical values and visual cues within the user's field of view. When performance is outside established targets, the system provides qualitative feedback and, for persistent deviations, escalates to explicit goal-directed instructions.
Percentage of Overall Excellent CPR
Percentage of chest compressions meeting the study-defined composite criterion for overall excellent CPR. This is a single composite outcome measure in which each chest compression is classified as meeting the outcome only when both compression rate and compression depth simultaneously meet American Heart Association Pediatric Advanced Life Support (AHA PALS) guideline targets. A compression must have both a rate of 100-120 compressions per minute and a depth of 5-6 cm to meet the composite outcome. If either the rate or depth is outside its target range, the compression does not meet the outcome. Rate and depth are therefore not evaluated as separate measurements for this primary outcome; they are simultaneous criteria used to determine whether each compression meets the single composite measure.
Percentage of Compressions Meeting Guideline Rate Target
Percentage of chest compressions delivered at the AHA PALS guideline-recommended rate of 100-120 compressions per minute. Measured during the 18-minute simulated pediatric cardiac arrest.
Percentage of Compressions Meeting Guideline Rate Depth
Percentage of chest compressions delivered at the AHA PALS guideline-recommended depth of 5-6 cm. Measured during the 18-minute simulated pediatric cardiac arrest.
Percentage of Compressions With Adequate Recoil
Percentage of chest compressions meeting the study-defined criterion for adequate chest recoil. During the 18-minute simulated pediatric cardiac arrest.
Percentage of Perfect CPR
Percentage of chest compressions simultaneously meeting study criteria for compression rate, depth, and recoil. Measured during the 18-minute simulated pediatric cardiac arrest.
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Johns Hopkins University
Lead sponsor
The Hospital for Sick Children
Collaborator
Columbia University
Collaborator
Brown University
Collaborator
Children's Hospital of Philadelphia
Collaborator
Johns Hopkins All Children's Hospital
Collaborator
Children's Medical Center Dallas
Collaborator
Baylor College of Medicine
Collaborator
Agency for Healthcare Research and Quality (AHRQ)
Collaborator
