CPR Guidance by an Emergency Physician via Video Call: A Simulation Study

Background. In South Korea, the prehospital treatment of cardiac arrest is generally led by an emergency medical technicianparamedic (EMT-P), and defbrillation is delivered by the automatic external defbrillator (AED). Tis study aimed at examining the efects of direct medical guidance by an emergency physician through a video call that enabled prompt manual defbrillation. Methods. Two-hundred eighty-eight paramedics based in Gyeonggi Province were studied for four months, from July to November 2015. Te participants were divided into 96 teams, and the teams were randomly divided into either a conventional group that was to use the AED or a video call guidance group which was to use the manual defbrillators, with 48 teams in each group. Te time to frst defbrillation, total hands-of time, and hands-of ratio were compared between the two groups. Results. Te median value of the time to the frst defbrillation was signifcantly shorter in the video call guidance group (56 s) than in the conventional group (73 s) (p<0.001). Te median value of the total hands-of time was also signifcantly shorter (228 vs. 285.5 s) (p<0.001), and the hands-of ratio, defned as the proportion of hands-of time out of the total CPR time, was signifcantly shorter in the video call guidance group (0.32 vs. 0.41) (p<0.001). Conclusion. Physician-guided CPR with a video call enabled prompt manual defbrillation and signifcantly shortened the time required for frst defbrillation, hands-of time, and hands-of ratio in simulated cases of prehospital cardiac arrest.