@article{Pedrotti:9302,
      recid = {9302},
      author = {Pedrotti, Marco and Terrier, Philippe and Gelin, Louis and  Stanek, Marc and Schirlin, Olivier},
      title = {Visual Fixation on the Thorax Predicts Bystander Breathing  Detection in Simulated Out-of-Hospital Cardiac Arrest, but  Video Debriefing With Eye Tracking Gaze Overlay Does Not  Enhance Postallocation Success Rate},
      journal = {Simulation in healthcare : journal of the society for  simulation in healthcare},
      address = {2021-11},
      number = {ARTICLE},
      pages = {8 p.},
      abstract = {Introduction: Bystander cardiopulmonary resuscitation in  out-of-hospital cardiac arrest is associated with higher  survival rates. Even trained health care staff cannot  assess breathing well enough to detect cardiac arrest.  Recognition of cardiac arrest by lay rescuers might be  overlooked in adult basic life support resuscitation  guidelines, which explain what to do, but not how to do it.  The 2015 Adult Advanced Life Support Resuscitation  Guidelines recommend to “look for chest movement.” We  hypothesize (1) that instructing lay rescuers
to look for  chest movement allows detecting breathing (or lack  thereof); (2) that showing a person their own recorded gaze  overlay during a video debriefing intervention enhances  breathing detection at postallocation; and (3) that the  more time spent looking at a cardiac
arrest victim's chest,  the greater the probability of detecting breathing (or lack  thereof).
Methods: Monocentric, blinded, prospective, 2-arm  parallel randomized controlled trial with balanced  randomization (1:1). The design entailed a preallocation  simulation, an intervention (video debriefing with or  without gaze overlay), and a postallocation simulation.
A  follow-up simulation took place after 6 months. The main  outcome measured was success in detecting breathing.  Participants were all prospective students of a bachelor's  degree program in nursing.
Results: All participants  performed better at postallocation (success rate at  preallocation = 59%, postallocation = 79%, χ2 = 7.22, P   0.01) regardless of viewing their own gaze
overlay during  video debriefing. We failed to obtain a sufficient number  of participants for the follow-up simulation. Instructing  lay rescuers to look for chest movement allows them to  detect breathing (or lack thereof). Each second spent  looking at the thorax increased the odds of successfully  detecting breathing by 38%. Mean thorax gaze duration  significantly
increased by 5.95 seconds (95% confidence  interval = 4.71–7.31) from preallocation (3.46 seconds, SD  = 4.16) to postallocation (9.41 seconds, SD = 5.98).  Laypersons' median diagnosis time was 15.5 seconds (range =  2–63 seconds), similar to another study (13 seconds, range  = 5–40 seconds).
Conclusions: This is the second study in  which the median time to decision exceeded the maximum 10  seconds recommended. International guidelines should  consider increasing the time allowed for the “check  breathing” step of bystander cardiopulmonary resuscitation  procedures.},
      url = {http://arodes.hes-so.ch/record/9302},
      doi = {https://doi.org/10.1097/SIH.0000000000000617},
}