• Christopher Plata, Miriam Stolz, Tobias Warnecke, Susanne Steinhauser, Jochen Hinkelbein, Wolfgang A Wetsch, Bernd W Böttiger, and Oliver Spelten.
• University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Anaesthesiology and Intensive Care Medicine, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: christopher.plata@uk-koeln.de.
• Resuscitation. 2019 Apr 1; 137: 87-93.

Purpose Of The StudyFeedback devices and dispatcher assistance increase CPR quality in bystander resuscitation. Yet, there is no data comparing both approaches with uninstructed CPR. The present prospective, randomized, controlled, manikin trial aims to determine the effects of the use of a smartphone application (PocketCPR) on CPR quality in a bystander CPR scenario compared to dispatcher-assisted telephone CPR and uninstructed CPR.Methods100 laypersons were included to perform 8-min CPR on a manikin. Volunteers were randomly assigned to one of four groups: (1) uninstructed CPR (uninstructed group), (2) dispatcher-assisted telephone CPR (telephone-group), (3) guidance and feedback through a smartphone application (app-group) and (4) dispatcher-assisted telephone CPR combined with the smartphone-app (telephone + app-group).Results And DiscussionThere was no significant difference in the time to first compression between the uninstructed and the app-group (p = 0.052), likewise between the telephone- and the telephone + app-group (p = 0.193). The no-flow-time of the uninstructed group was significantly longer compared to all other groups (p < 0.001). Median compression rate was significantly higher and within the recommended range in the app- and the telephone + app-group. There was no significant difference regarding correct compression depth between the four groups. Correct hand position and complete thorax release was found significantly more frequently in groups with smartphone-app support.ConclusionsFeedback by a smartphone application can improve bystander CPR quality in terms of no-flow-time, compression rate, correct hand position, thorax release and does not delay CPR onset. However, the use of a smartphone application does not improve compression depth significantly.Copyright © 2019 Elsevier B.V. All rights reserved.

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