7
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      To submit your manuscript to JMIR, please click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Impact of a Mobile App on Paramedics’ Perceived and Physiologic Stress Response During Simulated Prehospital Pediatric Cardiopulmonary Resuscitation: Study Nested Within a Multicenter Randomized Controlled Trial

      research-article
      , MMed 1 , , EMT-P 2 , , PhD 1 , 3 , , RNCS 4 , , RNCS 4 , , MD 1 , 5 , , MD 1 , 6 , , MPH, MD 1 , 7 , , MD 1 , 4 , , PhD 1 , 7 , , MD 1 , 4 , , MD 1 , 4 , , PedAMINES Prehospital Group 8
      (Reviewer), (Reviewer), (Reviewer)
      JMIR mHealth and uHealth
      JMIR Publications
      cardiopulmonary resuscitation, drugs, emergency medical services, medication errors, mobile health, mobile apps, out-of-hospital cardiac arrest, paramedics, pediatrics, State-Trait Anxiety Inventory, stress

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Out-of-hospital cardiac arrests (OHCAs) are stressful, high-stake events that are associated with low survival rates. Acute stress experienced in this situation is associated with lower cardiopulmonary resuscitation performance in calculating drug dosages by emergency medical services. Children are particularly vulnerable to such errors. To date, no app has been validated to specifically support emergency drug preparation by paramedics through reducing the stress level of this procedure and medication errors.

          Objective

          This study aims to determine the effectiveness of an evidence-based mobile app compared with that of the conventional preparation methods in reducing acute stress in paramedics at the psychological and physiological levels while safely preparing emergency drugs during simulated pediatric OHCA scenarios.

          Methods

          In a parent, multicenter, randomized controlled trial of 14 emergency medical services, perceived and physiologic stress of advanced paramedics with drug preparation autonomy was assessed during a 20-minute, standardized, fully video-recorded, and highly realistic pediatric OHCA scenario in an 18-month-old child. The primary outcome was participants’ self-reported psychological stress perceived during sequential preparations of 4 intravenous emergency drugs (epinephrine, midazolam, 10% dextrose, and sodium bicarbonate) with the support of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app designed to help pediatric drug preparation (intervention) or conventional methods (control). The State-Trait Anxiety Inventory and Visual Analog Scale questionnaires were used to measure perceived stress. The secondary outcome was physiologic stress, measured by a single continuous measurement of the participants’ heart rate with optical photoplethysmography.

          Results

          From September 3, 2019, to January 21, 2020, 150 advanced paramedics underwent randomization. A total of 74 participants were assigned to the mobile app (intervention group), and 76 did not use the app (control group). A total of 600 drug doses were prepared. Higher State-Trait Anxiety Inventory–perceived stress increase from baseline was observed during the scenario using the conventional methods (mean 35.4, SD 8.2 to mean 49.8, SD 13.2; a 41.3%, 35.0 increase) than when using the app (mean 36.1, SD 8.1 to mean 39.0, SD 8.4; a 12.3%, 29.0 increase). This revealed a 30.1% (95% CI 20.5%-39.8%; P<.001) lower relative change in stress response in participants who used the app. On the Visual Analog Scale questionnaire, participants in the control group reported a higher increase in stress at the peak of the scenario (mean 7.1, SD 1.8 vs mean 6.4, SD 1.9; difference: −0.8, 95% CI −1.3 to −0.2; P=.005). Increase in heart rate during the scenario and over the 4 drugs was not different between the 2 groups.

          Conclusions

          Compared with the conventional method, dedicated mobile apps can reduce acute perceived stress during the preparation of emergency drugs in the prehospital setting during critical situations. These findings can help advance the development and evaluation of mobile apps for OHCA management and should be encouraged.

          Trial Registration

          ClinicalTrials.gov NCT03921346; https://clinicaltrials.gov/ct2/show/NCT03921346

          International Registered Report Identifier (IRRID)

          RR2-10.1186/s13063-019-3726-4

          Related collections

          Most cited references89

          • Record: found
          • Abstract: not found
          • Article: not found

          Fitting Linear Mixed-Effects Models Usinglme4

            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

            (2013)
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              User Acceptance of Information Technology: Toward a Unified View

                Bookmark

                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                October 2021
                7 October 2021
                : 9
                : 10
                : e31748
                Affiliations
                [1 ] University of Geneva Faculty of Medicine Geneva Switzerland
                [2 ] A.C.E. Geneva Ambulances SA Geneva Switzerland
                [3 ] Division of Clinical Epidemiology, Department of Health and Community Medicine Geneva University Hospitals Geneva Switzerland
                [4 ] Department of Pediatric Emergency Medicine, Geneva Children’s Hospital Geneva University Hospitals Geneva Switzerland
                [5 ] Department of Emergency Medicine Geneva University Hospitals Geneva Switzerland
                [6 ] Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine Geneva University Hospitals Geneva Switzerland
                [7 ] Division of Medical Information Sciences, Department of Radiology and Medical Informatics Geneva University Hospitals Geneva Switzerland
                [8 ] See Authors’ Contributions
                Author notes
                Corresponding Author: Johan N Siebert Johan.Siebert@ 123456hcuge.ch
                Author information
                https://orcid.org/0000-0003-0827-7496
                https://orcid.org/0000-0003-0754-2796
                https://orcid.org/0000-0003-2631-4780
                https://orcid.org/0000-0002-3223-1810
                https://orcid.org/0000-0003-4348-8352
                https://orcid.org/0000-0001-6989-6421
                https://orcid.org/0000-0002-8549-7997
                https://orcid.org/0000-0002-2681-8076
                https://orcid.org/0000-0002-8925-5936
                https://orcid.org/0000-0001-9734-3242
                https://orcid.org/0000-0001-9603-5520
                https://orcid.org/0000-0002-2871-3382
                Article
                v9i10e31748
                10.2196/31748
                8532016
                34617916
                c960b744-c781-40a4-8377-0ba88b7ffad2
                ©Matthieu Lacour, Laurie Bloudeau, Christophe Combescure, Kevin Haddad, Florence Hugon, Laurent Suppan, Frédérique Rodieux, Christian Lovis, Alain Gervaix, Frédéric Ehrler, Sergio Manzano, Johan N Siebert, PedAMINES Prehospital Group. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 07.10.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 2 July 2021
                : 23 July 2021
                : 5 August 2021
                : 8 August 2021
                Categories
                Original Paper
                Original Paper

                cardiopulmonary resuscitation,drugs,emergency medical services,medication errors,mobile health,mobile apps,out-of-hospital cardiac arrest,paramedics,pediatrics,state-trait anxiety inventory,stress

                Comments

                Comment on this article