Telemedicine in cardiac arrest protocols: Comparative impact of video and audio dispatcher assistance

Table 2 Inclusion of a summary of the studies, n (%)

Ref.	Linderoth et al[22], 2021	Ofoma et al[26], 2022		Plata et al[18], 2021	Lee et al[27], 2021			Aranda-García et al[16], 2023		Pérez Alonso et al[14], 2017		Lee et al[28], 2020		Ecker et al 2021[35]		Yang et al[29], 2009
Comparators	Video	Telemedicine	No telemedicine	Video	V-DACPR with rapid transition	V-DACPR with delayed transition	C-DACPR	Video	Audio	GG	Control	Video	Audio	Audio and video telephony		Video	Audio
Country	Denmark	United States		Germany	South Korea			Spain		Spain		Seoul, South Korea		Germany		Taiwan
Study period	2019-2021	July 1, 2017, and December 31, 2019		September 2019 to February 2020	October 2019 to July 2020			2021-2022		November 2014 to July 2015		2017		August to September 2018		2009
Study design	Retrospective study	A prospective, voluntary, multi-site registry of IHCA		Randomised controlled simulation trial	Randomised controlled simulation trial			Randomised controlled simulation trial		Randomised clinical simulation		Retrospective cohort		Prospective randomized pilot		Randomized controlled study
Sample size	90	14373	30212	93	43	45	43	14	14	36	36	231	1489	54 venues with realistic full-scale CPR mannequin		43	53
Participants	Bystander	Adult patients		Paramedics and emergency physicians	Bystander			Adult volunteers		Nurse		Emergency medical technicians		Bystander		Volunteers (bystander)
Inclusion criteria	The training included simulation-based scenarios with unconscious patients and cardiac arrest cases with a focus on high-quality CPR with simultaneously real-time guidance (video-instructed DA-CPR)	We identified 70881 patients 18 years or older with an index pulseless IHCA between July 1, 2017, and December 31, 2019. We excluded arrests at hospitals that did not respond to the AHA surveys or had missing information on TCC availability; at hospitals with less than 10 cardiac arrests over the study period; that occurred outside of an ICU or hospital ward (e.g., emergency room and operating room); and in patients with an implantable cardioverterdefibrillator. Additionally, we excluded patients with missing information related to arrest time or survival		No specefic criteria	Volunteers aged 18 years or older were recruited for the simulation trial from October 2019 to July 2020. Healthcare providers, and participants with chronic lung diseases, cardiovascular diseases, visual disabilities, or hearing disabilities were excluded during initial enrollment. Written consent was obtained from all participants			Inclusion criteria were no theoretical or practical training on BLS in the previous 2 years		Training in BLS in the last 2 years and a minimum of 2 years of professional experience in emergency services as well as familiarity with the use of AED and the ALS		OHCA patients with a presumed cardiacetiology who were more than 18 years of age between January and December 2017		NR		Ninety-six adults without CPR training within 5 years were recruited
Age (years)	21.25 (11.17)	65.5 (15.4)	65.6 (15.1)	NR	30.5 (12.0)	29.1 (10.2)	30.8 (12.1)	23	23	33 ± 8	32 ± 7	NR	NR	NR	NR	50.1 ± 11.5	50.4 ± 12.7
BMI (kg/m2)	NR	NR	NR	NR	NR	NR	NR	22.5	22.1	NR	NR	NR	NR	NR	NR	NR	NR
Male	50	8500 (59.1)	17724 (58.7)	NR	10	11	9	14	14	39%	28%	NR	NR	NR	NR	NR	NR
Female	40	5873 (40.9)	12488 (41.3)	NR	33	34	34	0	0	61%	72%	NR	NR	NR	NR	NR	NR
Has provided CPR	52	NR	NR	93	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	4 (70)	1 (90)
Witnessed an emergency	29	NR	NR	93	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	-	-
Had first aid course	48	NR	NR	93	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	18 (60)	18 (90)

BMI: Body mass index; CPR: Cardiopulmonary resuscitation; DA-CPR: Dispatcher-assisted cardiopulmonary resuscitation; NR: Not reported; IHCA: In-hospital cardiac arrest; OHCA: Out-of-hospital cardiac arrest; AHA: American Heart Association; TCC: Telemedicine critical care; ICU: Intensive care unit; V-DACPR: Video dispatcher-assisted cardiopulmonary resuscitation; T-DACPR: Telephone dispatcher-assisted cardiopulmonary resuscitation; BLS: Basic life support; AED: Automated external defibrillator; ALS: Advanced life support.