000009302 001__ 9302 000009302 005__ 20230905152541.0 000009302 022__ $$a1559-2332 000009302 0247_ $$2DOI$$a10.1097/SIH.0000000000000617 000009302 037__ $$aARTICLE 000009302 039_9 $$a2023-09-05 15:25:41$$b1$$c2023-06-06 10:12:14$$d1001252$$c2022-01-19 10:18:24$$d1000077$$c2022-01-19 10:18:21$$d0$$c2022-01-17 14:34:05$$d0$$c2022-01-17 08:43:10$$d1000077$$y2022-01-14 09:45:19$$z1000077 000009302 041__ $$aeng 000009302 245__ $$aVisual 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 000009302 269__ $$a2021-11 000009302 300__ $$a8 p. 000009302 506__ $$avisible 000009302 520__ $$9eng$$aIntroduction: 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. 000009302 540__ $$acorrect 000009302 592__ $$aHE-Arc Santé 000009302 592__ $$bRecherche appliquée et développement de la HE-ARC Santé 000009302 592__ $$cSanté 000009302 592__ $$dSoins infirmiers 000009302 65017 $$aSanté 000009302 6531_ $$9eng$$aOut-of-hospital 000009302 6531_ $$9eng$$acardiac arrest 000009302 6531_ $$9eng$$asimulation 000009302 6531_ $$9eng$$abreathing detection 000009302 6531_ $$9eng$$acardiopulmonary 000009302 6531_ $$9eng$$aresuscitation, 000009302 6531_ $$9eng$$aeye tracking 000009302 6531_ $$9eng$$aeye movements 000009302 655__ $$ascientifique 000009302 700__ $$aPedrotti, Marco$$uHaute Ecole Arc Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale 000009302 700__ $$aTerrier, Philippe$$uHaute Ecole Arc Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale 000009302 700__ $$aGelin, Louis$$uHaute Ecole Arc Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale 000009302 700__ $$aStanek, Marc$$uHaute Ecole Arc Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale 000009302 700__ $$aSchirlin, Olivier$$uHaute Ecole Arc Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale 000009302 773__ $$jto be published$$tSimulation in healthcare : journal of the society for simulation in healthcare 000009302 8564_ $$yPublished version$$9f2183b19-f879-4a7c-95b9-6943887b39c5$$s540195$$uhttps://arodes.hes-so.ch/record/9302/files/Published%20version.pdf 000009302 906__ $$aGOLD 000009302 909CO $$ooai:hesso.tind.io:9302$$pGLOBAL_SET 000009302 950__ $$aSan2 000009302 980__ $$ascientifique 000009302 981__ $$ascientifique