Resuscitation 93 (2015) e1–e2
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor
RELIVE Tracking for quality cardiopulmonary resuscitation training: An experimental comparison with a standard CPR training mannequin Sir, The most widely used and recognized approach to train high quality basic life support (BLS) manoeuvres and automated external defibrillation (AED) remains the classic instructor-led training course. A recent review, however, introduced new evidence in support to alternative methods of training, including the use of selfdirected learning and CPR feedback/prompt devices.1 For the Viva! Campaign 2014, the Italian Resuscitation Council developed a new and more ambitious project called “Relive” game.2 In this article, we propose a new markerless solution3,4 called RELIVE Tracking still developed within the Mini-VREM project,5 which is able to accurately estimate chest compressions depth and rate during chest compression. In addition, RELIVE Tracking has been tested with two different RGB-D (Red Green Blue-Depth) sensors based on different technologies featuring different prizes (Kinect® v1, Microsoft, Redmond, WA, USA and Creative Senz3D® , Creative Technology, Singapore, Republic of Singapore) and has been provided of a gamelike realistic interface used for conveying a 3D visual feedback to the user/rescuer. The RELIVE Tracking software (the engineer’s heart of Relive Game) was specifically developed, to guide the training and to improve the quality of chest compression (CC) by tracking the hands of the user, without the need of any marker. RELIVE Tracking features a game-like Graphical User Interface (GUI) (Fig. 1) that allows non-experts to intuitively access all the application. RELIVE Tracking was tested with both RGB-D sensors, on a sample of ten healthy subjects to evaluate the effect of the proposed software on CC performance. This study was carried out at the PERCRO Laboratory in Pisa in August 2014. Ten male participants were recruited from students and researchers (non-CPR experts) at the PERCRO Laboratory. For each participant, the experiment consisted of a group of three trials of CC each lasting 30 s and characterized by a different depth CC (4–6 cm). Each group of trials was repeated for each of the two RGB-D sensors, 60 trials in total. For each of the 60 trials, the data were simultaneously acquired with RELIVE Tracking and with a traditional training mannequin (Resusci Anne – RA, Laerdal Medical, Stavanger, Norway) that was used for a quantitative evaluation of the accuracy of CC depth measured with RELIVE Tracking. The best RELIVE Tracking performance was obtained with RELIVE Tracking using Microsoft Kinect® v1, with an average square quadratic error equal to 4.3 ± 0.3 mm, whereas the worst was with the Creative Senz3d® with a mean square quadratic error equal to 6.5 ± 0.3 mm. Considering RELIVE Tracking as a low-cost training http://dx.doi.org/10.1016/j.resuscitation.2015.04.002 0300-9572/© 2015 Elsevier Ireland Ltd. All rights reserved.
Fig. 1. The RELIVE Tracking user interface.
platform, not for clinical use, the error committed by RELIVE Tracking is acceptable to anticipate its potential future implementation in training programs for general population with a gamification approach. Conflict of interest statement Italian Resuscitation Council, PERCRO Laboratory and Studio Evil received a no-profit grant to build a no profit serious game from CZ Health Insurance Netherlands. Mini-VREM team is the winner of the Future of Health Award 2012. The award is a joint initiative of CZ healthcare insurance and Games for Health Europe. References 1. Koster RW, Baubin MA, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2010;81:1277–92. 2. Semeraro F, Frisoli A, Ristagno G, et al. Relive: a serious game to learn how to save lives. Resuscitation 2014;85:e109–10. 3. Wattanasoontorn V, Magdics M, Boada I, Sbert M. A kinect-based system for cardiopulmonary resuscitation simulation: a pilot study in Serious Games Development and Applications. Springer; 2013. p. 51–63. 4. Tolk A, Miller GT, Cross AE, Maestri J, Cawrse B. Aims: applying game technology to advance medical education. Comput Sci Eng 2013;15:82–91. 5. Semeraro F, Frisoli A, Loconsole C, et al. Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality training: a randomised crossover mannequin pilot study. Resuscitation 2013;84:501–7.
Claudio Loconsole Antonio Frisoli Nicola Mastronicola Fabio Stroppa
e2
Letter to the Editor / Resuscitation 93 (2015) e1–e2
PERCRO Laboratory, TeCIP Institute, Scuola Superiore Sant’Anna, Pisa, Italy Giuseppe Ristagno Dipartimento di Ricerca Cardiovascolare, IRCCS-Istituto di ricerche farmacologiche “Mario Negri” – IRCCS, Milano, Italy Luca Marchetti CEO Studio Evil, Bologna, Italy
Federico Semeraro ∗ Anaesthesia and Intensive Care, Ospedale Maggiore, Bologna, Italy ∗ Corresponding author. E-mail address: [email protected] (F. Semeraro)
21 March 2015
Contents lists available at ScienceDirect
Resuscitation journal homepage: www.elsevier.com/locate/resuscitation
Letter to the Editor
RELIVE Tracking for quality cardiopulmonary resuscitation training: An experimental comparison with a standard CPR training mannequin Sir, The most widely used and recognized approach to train high quality basic life support (BLS) manoeuvres and automated external defibrillation (AED) remains the classic instructor-led training course. A recent review, however, introduced new evidence in support to alternative methods of training, including the use of selfdirected learning and CPR feedback/prompt devices.1 For the Viva! Campaign 2014, the Italian Resuscitation Council developed a new and more ambitious project called “Relive” game.2 In this article, we propose a new markerless solution3,4 called RELIVE Tracking still developed within the Mini-VREM project,5 which is able to accurately estimate chest compressions depth and rate during chest compression. In addition, RELIVE Tracking has been tested with two different RGB-D (Red Green Blue-Depth) sensors based on different technologies featuring different prizes (Kinect® v1, Microsoft, Redmond, WA, USA and Creative Senz3D® , Creative Technology, Singapore, Republic of Singapore) and has been provided of a gamelike realistic interface used for conveying a 3D visual feedback to the user/rescuer. The RELIVE Tracking software (the engineer’s heart of Relive Game) was specifically developed, to guide the training and to improve the quality of chest compression (CC) by tracking the hands of the user, without the need of any marker. RELIVE Tracking features a game-like Graphical User Interface (GUI) (Fig. 1) that allows non-experts to intuitively access all the application. RELIVE Tracking was tested with both RGB-D sensors, on a sample of ten healthy subjects to evaluate the effect of the proposed software on CC performance. This study was carried out at the PERCRO Laboratory in Pisa in August 2014. Ten male participants were recruited from students and researchers (non-CPR experts) at the PERCRO Laboratory. For each participant, the experiment consisted of a group of three trials of CC each lasting 30 s and characterized by a different depth CC (4–6 cm). Each group of trials was repeated for each of the two RGB-D sensors, 60 trials in total. For each of the 60 trials, the data were simultaneously acquired with RELIVE Tracking and with a traditional training mannequin (Resusci Anne – RA, Laerdal Medical, Stavanger, Norway) that was used for a quantitative evaluation of the accuracy of CC depth measured with RELIVE Tracking. The best RELIVE Tracking performance was obtained with RELIVE Tracking using Microsoft Kinect® v1, with an average square quadratic error equal to 4.3 ± 0.3 mm, whereas the worst was with the Creative Senz3d® with a mean square quadratic error equal to 6.5 ± 0.3 mm. Considering RELIVE Tracking as a low-cost training http://dx.doi.org/10.1016/j.resuscitation.2015.04.002 0300-9572/© 2015 Elsevier Ireland Ltd. All rights reserved.
Fig. 1. The RELIVE Tracking user interface.
platform, not for clinical use, the error committed by RELIVE Tracking is acceptable to anticipate its potential future implementation in training programs for general population with a gamification approach. Conflict of interest statement Italian Resuscitation Council, PERCRO Laboratory and Studio Evil received a no-profit grant to build a no profit serious game from CZ Health Insurance Netherlands. Mini-VREM team is the winner of the Future of Health Award 2012. The award is a joint initiative of CZ healthcare insurance and Games for Health Europe. References 1. Koster RW, Baubin MA, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2010;81:1277–92. 2. Semeraro F, Frisoli A, Ristagno G, et al. Relive: a serious game to learn how to save lives. Resuscitation 2014;85:e109–10. 3. Wattanasoontorn V, Magdics M, Boada I, Sbert M. A kinect-based system for cardiopulmonary resuscitation simulation: a pilot study in Serious Games Development and Applications. Springer; 2013. p. 51–63. 4. Tolk A, Miller GT, Cross AE, Maestri J, Cawrse B. Aims: applying game technology to advance medical education. Comput Sci Eng 2013;15:82–91. 5. Semeraro F, Frisoli A, Loconsole C, et al. Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality training: a randomised crossover mannequin pilot study. Resuscitation 2013;84:501–7.
Claudio Loconsole Antonio Frisoli Nicola Mastronicola Fabio Stroppa
e2
Letter to the Editor / Resuscitation 93 (2015) e1–e2
PERCRO Laboratory, TeCIP Institute, Scuola Superiore Sant’Anna, Pisa, Italy Giuseppe Ristagno Dipartimento di Ricerca Cardiovascolare, IRCCS-Istituto di ricerche farmacologiche “Mario Negri” – IRCCS, Milano, Italy Luca Marchetti CEO Studio Evil, Bologna, Italy
Federico Semeraro ∗ Anaesthesia and Intensive Care, Ospedale Maggiore, Bologna, Italy ∗ Corresponding author. E-mail address: [email protected] (F. Semeraro)
21 March 2015
