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Sudden cardiac arrest is a major public health issue, and EMS dispatchers play a key role in improving outcomes through telephone-assisted CPR (T-CPR). With current technology, video-assisted CPR (V-CPR) via smartphones allows for visual feedback and more precise guidance. While V-CPR has shown promise, studies have mostly focused on adult CPR performance in controlled settings. Research involving children and non-CPR first aid scenarios is scarce. Our study addresses this gap by evaluating video-assisted guidance during a simulated unconsciousness situation performed by children, exploring its feasibility and broader applicability.
Sudden cardiac arrest is a major public health concern and remains one of the leading causes of death in industrialized countries. Emergency Medical Services (EMS) dispatchers play a crucial role in recognizing cardiac arrest and guiding lay responders through telephone-assisted CPR (T-CPR), which has been shown to improve survival outcomes. With current technologies, real-time video communication via a bystander's smartphone has become feasible, enabling video-assisted CPR (V-CPR), which allows dispatchers to provide visual feedback and more tailored guidance.
Although several studies have investigated the effectiveness of V-CPR-mainly in terms of chest compression quality and time to first compression-these have primarily focused on adult participants and controlled settings. Research involving children as lay responders is limited, and video-assisted first aid has been scarcely evaluated in pediatric populations. Moreover, existing studies concentrate predominantly on CPR, while other essential first aid scenarios, such as the management of unconscious victims, remain underexplored.
To address these gaps, our study examined the effectiveness of video-assisted guidance during a simulated unconsciousness scenario performed by children, aiming to assess both the feasibility and potential benefits of extending video-assisted firs aid approaches beyond cardiac arrest.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Training and video-assistance | Experimental | Received a 45-minute theoretical and practical training session on assessing unconsciousness and managing an unresponsive victim, based on ILCOR first aid guidelines, followed by a 15-minute technical session on how to initiate and operate video assistance via a smartphone. Both sessions were conducted by a paramedic experienced in pediatric first aid education and emergency dispatching. |
|
| Video-assistance only | Experimental | Received a 15-minute technical session exclusively focused on operating the video assistance technology (without first aid instruction). This session was conducted by the same paramedic as in Group 1. |
|
| No assistance | No Intervention | Received no preparatory training (control group). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| First Aid Training Combined With Video-Assisted Guidance | Behavioral | Participants received a 45-minute structured first aid training session on unconscious victim management, followed by a 15-minute video-guidance instruction. During simulation, children received real-time video guidance from a dispatcher via smartphone. |
| Measure | Description | Time Frame |
|---|---|---|
| Correctness of treatment of an unconscious patient (based on a checklist). | Number of correct first aid steps performed and task completion success (based on the checklist containing all the relevant steps of the treatment). | During post-analysis of the video-records (within 1 week after data collection) |
| Measure | Description | Time Frame |
|---|---|---|
| Time | Time to task completion | During procedure. |
| Measure | Description | Time Frame |
|---|---|---|
| Helping attitude of the children (based on willingness to help). | Observable willingness to help (approach and engagement behavior during the simulated procedure). The proportion of children who dared to approach the victim and initiate care in the simulated scenario was measured. Based on this, participants were classified into "positive" and "negative" attitude groups. | During procedure. |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pécs Faculty of Health Sciences | Pécs | 7621 | Hungary |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41418494 | Derived | Mohacsi V, Banfai-Csonka H, Betlehem J, Banfai B. Video-assisted first aid enables trained 6-8-year-old children to help an unconscious adult: A quasy-experimental simulation study. Am J Emerg Med. 2026 Feb;100:193-197. doi: 10.1016/j.ajem.2025.12.008. Epub 2025 Dec 15. |
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| ID | Term |
|---|---|
| D014474 | Unconsciousness |
| ID | Term |
|---|---|
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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Children were allocated in pairs to one of three parallel intervention arms:
Training combined with video-guided assistance,
Video-guided assistance only, or
No intervention (control). Each pair participated in only one intervention condition without crossover. Parallel assignment allowed for comparison of outcomes between intervention strategies and the control group. Video guidance was provided live by a trained dispatcher during simulation scenarios.
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The dispatcher, assessors, actor, and children were informed about their specific tasks according to their group allocation but were blinded to the study design and intended outcomes.
|
| Video-Assisted Guidance Without Prior Training | Behavioral | Participants received a 15-minute instruction on video-assisted guidance use, without prior first aid training. During simulation, real-time video guidance was provided by a dispatcher via smartphone to assist with first aid tasks. |
|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |