Clinical Research Directory

The AIR-CPR Study: AI-Guided Chest Compressions

The AIR-CPR project aims to improve survival rates for patients with Out-of-Hospital Cardiac Arrest (OHCA) by utilizing Artificial Intelligence (AI) to optimize chest compression locations. Current guidelines recommend a standardized compression point (the lower half of the sternum), yet recent research indicates that this position can compress the aortic valve in approximately 48.7% of patients, significantly reducing the chances of successful resuscitation. This study will develop a deep learning model based on YOLO v8 to analyze real-time arterial pressure waveforms to identify proper aortic valve opening and closing. By identifying specific waveform features that humans cannot easily distinguish, the AI will guide rescuers to adjust the compression site-typically toward the left ventricle-to ensure optimal blood output. The project seeks to transform CPR from a standardized "one-size-fits-all" approach into a personalized, precision medicine intervention.

Evaluation of Mixed Reality Cardiopulmonary Resuscitation Training

\<Study Design\> This study is a cluster-randomized, stratified, non-inferiority trial designed to evaluate the feasibility, efficacy, and educational effectiveness of HEROS 4.0, a mixed-reality (MR)-based cardiopulmonary resuscitation (CPR) training system, compared with conventional instructor-led CPR training. \<Objective \& Hypothesis\> The primary objective is to determine whether MR-based HEROS 4.0 CPR training is non-inferior to standard video- and instructor-based CPR training in improving CPR performance quality. The central hypothesis is that participants trained using HEROS 4.0 will achieve comparable CPR quality to those trained using traditional methods, while benefiting from enhanced immersion, scalability, and accessibility. \<Participants\> A total of 120 adults aged 18-50 years who have not received CPR training within the previous 12 months will be recruited. Participants will be assigned to one of two clusters and randomized in a 1:1 ratio to either the HEROS 4.0 MR training group or the conventional CPR training group. \<Intervention \& Control\> Participants will undergo CPR training according to their assigned group: Intervention group (HEROS 4.0): Participants will receive a two-stage CPR training program consisting of pre-training and on-site MR-based training. As pre-training, participants will be instructed to watch a 40-minute instructional video (conventional CPR training group video) at home prior to their visit. After completing the pre-training, participants will undergo 20 minutes of MR-based CPR training using the HEROS 4.0 system in a dedicated CPR training booth. Control group (Conventional CPR training): Participants will receive 60 minutes of standard CPR education delivered through instructional videos and in-person instructor guidance, reflecting current community CPR training practice. \<Outcomes\> Immediately after training, all participants will undergo a standardized cardiac arrest simulation using a CPR quality-measurement manikin. This simulation will assess objective CPR performance metrics as well as subjective outcomes through questionnaires. To evaluate knowledge retention and skill durability, all assessments will be repeated 6 months after training using the same simulation scenario and outcome measures. The primary outcome is chest compression fraction measured during the standardized simulated cardiac arrest scenario. Secondary outcomes include quantitative measures of CPR quality and participant-reported outcomes based on survey.

The Effect of Escape Room Simulation on Nursing Students' Clinical Decision-Making and Teamwork Attitudes Regarding Cardiopulmonary Resuscitation

The study was planned as a randomized controlled trial with a pre-test-post-test-follow-up design involving experimental and control groups. All students who agree to participate in the study will be administered the Descriptive Characteristics Form, the Clinical Decision-Making Scale in Nursing (pre-test)", and the "Teamwork Attitudes Scale (pre-test)". Students will be assigned to experimental and control groups using a simple randomization method. Students in the experimental group will receive a lecture on cardiopulmonary resuscitation from the researcher. Following the lecture, an escape room simulation will be conducted. Each escape room simulation will be conducted with 6 students, consisting of a pre-information session, an escape room simulation application, and an analysis session. In the pre-information session, the simulation objectives, the purpose of the scenario, the roles within the scenario, and the game rules will be explained, and the escape room and standard patient will be briefly introduced to the students in the meeting room. Then, students will perform the scenario and game activity (KAHOOT, Table Game, Card Game, Word Cloud, Crossword Puzzle) with a standard patient in the simulation laboratory prepared as an escape room. The researcher will act as a facilitator during the escape room simulation application. During the simulation, if the expected steps are not performed correctly or the game activity is not successfully completed, the team has the right to request hints from the facilitator. Immediately after the escape room simulation is completed, a debriefing session will be held. The debriefing session, lasting approximately 20-30 minutes for each team, will take place in the meeting room located directly opposite the escape room. During the debriefing session, students will be encouraged to express their feelings and thoughts, and feedback will be provided by the researcher. After the debriefing session, and after 1 month the "Clinical Decision-Making Scale in Nursing (post-test)" and the "Teamwork Attitudes Scale (post-test)" will be administered. All students in the control group will be given training on cardiopulmonary resuscitation by the researcher using a traditional training method. After the training is completed, and after 1 month the Clinical Decision-Making Scale in Nursing (post-test) and the "Teamwork Attitudes Scale (post-test)" will be administered. Data analysis will be performed using the IBM SPSS Statistics 26 software package. The main research questions are: Does escape room simulation improve nursing students' clinical decision-making levels regarding cardiopulmonary resuscitation (CPR) practice? Does escape room simulation improve nursing students' teamwork attitudes regarding CPR practice?

A Study on the Impact of a New Canton-Wide First Responder System in Zug, Switzerland, on Survival After Adult Cardiac Arrest-Examining Early Life-Saving Organized Help, Fast Defibrillation, and Improved Outcomes for Out of Hospital Cardiac Arrest

REVIVE Zug: Improving Emergency Response for Out-of-Hospital Cardiac Arrest Out-of-hospital cardiac arrest (OHCA) represents one of the most time-critical medical emergencies, where rapid recognition and immediate intervention are decisive for survival and neurological outcome. Early activation of emergency services, prompt initiation of cardiopulmonary resuscitation, and rapid defibrillation using automated external defibrillators (AEDs) are key components of the chain of survival. In many regions, organized First Responder systems-such as fire services, police forces, and trained lay responders supported by dispatcher-assisted instructions-arrive at the scene before emergency medical services (EMS) and initiate life-saving measures. Evidence from multiple EMS systems indicates that the early involvement of First Responders is associated with higher rates of return of spontaneous circulation (ROSC) and improved survival to hospital discharge with favorable neurological outcomes. Regions with well-established First Responder networks consistently report better OHCA outcomes compared with regions without such systems. In the canton of Zug, a comprehensive First Responder system has recently been implemented alongside an established hybrid EMS response model. In this system, resuscitation efforts are led either by an Emergency Physician (EP) or by a highly trained Critical Care Paramedic (CCP), depending on operational availability. Both roles operate within clearly defined competencies and provide the full scope of advanced prehospital care. This hybrid leadership model offers a unique opportunity to examine whether the professional background of the team leader influences resuscitation outcomes in real-world clinical practice. The REVIVE Zug study aims to evaluate the impact of the canton-wide First Responder system on outcomes following OHCA. Key outcomes of interest include ROSC rates, hospital admission after cardiac arrest, the occurrence of shockable rhythms at EMS arrival, and outcomes achieved before EMS arrival. In addition, the study explores whether team leadership by an EP or a CCP is associated with differences in resuscitation outcomes. Further analyses focus on time intervals within the chain of survival, such as time from cardiac arrest to arrival of organized help and time to first defibrillation, as well as on event timing and basic demographic characteristics. The study is based on anonymized data from established EMS quality registries and the national Swiss Reca database. By comparing OHCA cases before and after implementation of the comprehensive First Responder system, the project seeks to provide robust, practice-oriented evidence to inform future development of prehospital emergency care systems in Switzerland and comparable settings.

Effect of Electrically Insulated Gloves on ROSC Time, End-tidal CO₂ Response, Survival and Morbidity in Uninterrupted CPR

Cardiopulmonary arrest is the sudden cessation of spontaneous breathing and circulation due to various causes. Cardiopulmonary resuscitation (CPR) is the set of decisions and procedures encompassing all efforts aimed at restoring spontaneous circulation. Guidelines are published at regular intervals by the American Heart Association (AHA) and the European Resuscitation Council (ERC) to ensure that these procedures are applied uniformly worldwide. According to the AHA and ERC guidelines, the latest approach to CPR is to reduce the duration of interruptions in chest compressions, which is a component of high-quality CPR. Prior to actual patient intervention, a preliminary test will be conducted on an advanced life support simulation manikin to evaluate the safety and feasibility of the method. During cardiopulmonary resuscitation (CPR), unavoidable interruptions in chest compressions occur because contact with the patient must be broken during defibrillation and cardioversion. In this study, electrically insulated composite gloves (Class 2) will be used to ensure uninterrupted chest compressions during defibrillation, and the effect of this practice on patients' ROSC, EtCO₂, neurological outcomes, and survival rates will be evaluated comparatively with the control group. The main objective of the study is to evaluate the effect of ensuring uninterrupted chest compressions during defibrillation using electrically insulated composite gloves on patient survival rates.

Learning Cardiopulmonary Resuscitation in the School Setting: RCP-KNOW Project.

Title: Out-of-hospital cardiorespiratory arrest and learning cardiopulmonary resuscitation in the school setting: evidence synthesis. CPR-KNOW PROYECT. Background: The high incidence, associated morbidity and mortality, and the great individual, social and economic impact of out-of-hospital cardiorespiratory arrest (OHCA) make it a priority for all health systems worldwide. To increase the rates of potential first responders who act appropriately, applying basic life support (BLS) measures in the OHCA, the European Resuscitation Council includes among its latest recommendations the training of all school children through the "Kids Save Lives" initiative. Objectives: to determine, through a randomized clinical trial, the effectiveness of two training strategies for increasing theoretical and practical knowledge of BLS in schoolchildren and adolescents. Methodology: To evaluate the effectiveness of two (Cardiopulmonary Resuscitation) CPR teaching interventions in improving the following outcome variables: theoretical knowledge and practical skills, CPR quality; as well as its relationship with the anthropometric, sociodemographic and physical condition variables of the schoolers. * Intervention group 1 (IG1): a 2-hour theoretical-practical session on the BLS sequence taught by a Nursing professional performing the practice with a mannequin. Instructor/school ratio: 1/25 for the theoretical session and a school/mannequin ratio: 2-3/1. * Intervention group 2 (IG2): a session with short video (approximately 5-10 min) and other teaching resources (puzzle), without practice on a mannequin. Video/school ratio: 1/25 and a school/teaching resource (puzzle) ratio: 1/1.

Parental Knowledge of First Aid for Choking and Cardiopulmonary Resuscitation in Infants Under One Year of Age

This study aims to assess the knowledge of parents regarding first aid for choking and cardiopulmonary resuscitation (CPR) in infants under one year of age. The primary objective is to evaluate how well parents understand emergency procedures and identify factors influencing their knowledge and confidence. The study will involve a combination of surveys and practical training sessions conducted both in-person and online.