An interventional study of AR-CPR in Cardiac Arrest (CA), Pediatric Cardiac Arrest (Simulated) and Cardiopulmonary Resuscitation (CPR), sponsored by Johns Hopkins University. Recruiting at 8 sites in 2 countries. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-26.
Sponsored by Johns Hopkins University · Not applicable, Interventional, and Other
This study evaluates whether an augmented reality cardiopulmonary resuscitation feedback system (AR-CPR) can support health care providers in delivering high-quality chest compressions during pediatric cardiac arrest. AR-CPR provides real-time visual feedback on chest compression rate, depth, and recoil through a head-mounted augmented reality display.
In this randomized, multicenter, international, simulation-based non-inferiority study, health care providers perform chest compressions during an 18-minute simulated pediatric cardiac arrest. Participants are assigned to receive either real-time feedback from AR-CPR or coaching from a trained human CPR coach. The primary objective is to determine whether the percentage of chest compressions meeting guideline targets for both rate and depth with AR-CPR is non-inferior to that achieved with human CPR coaching.
This prospective, multicenter, international, randomized, unblinded, non-inferiority study evaluates an augmented reality cardiopulmonary resuscitation feedback system (AR-CPR) compared with traditional human-delivered quality CPR coaching during simulated pediatric cardiac arrest. The study uses a standardized 18-minute pediatric cardiopulmonary arrest simulation conducted across eight participating institutions in the United States and Canada.
Participants are actively credentialed pediatric emergency department or intensive care unit nurses and clinical technicians with current Pediatric Advanced Life Support (PALS) certification and prior experience or training functioning as quality CPR coaches. Participants are organized into teams of one to three members and perform chest compressions on a standardized high-fidelity pediatric manikin during a simulated non-shockable cardiac arrest involving an intubated 7-year-old child. The simulation is limited to chest compression performance to isolate the effect of the feedback modality on CPR quality.
Participants are randomized at the team level to one of two study arms. In the control arm, an experienced, trained CPR coach provides real-time, goal-directed feedback based on chest compression rate, depth, and recoil. In the intervention arm, participants use AR-CPR, a head-mounted augmented reality system that provides real-time visual feedback on these same CPR performance measures. AR-CPR displays numerical and visual feedback within the participant's field of view and provides escalating goal-directed guidance when CPR performance falls outside established targets.
CPR performance data are collected using the same AR-CPR sensor system in both study arms to provide standardized objective measurement. The study evaluates whether CPR performance with AR-CPR is non-inferior to performance achieved with a trained human CPR coach. The primary measure of CPR performance is the percentage of compressions simultaneously meeting American Heart Association guideline targets for compression rate and depth. Additional assessments characterize other measures of CPR quality and participants' cognitive workload and experience with the augmented reality system.
926 studies on the registry are indexed under Heart Arrest; 226 are open to participants now.
This study's planned enrollment of 252 is above the median of 100 across 518 interventional studies indexed under Heart Arrest.
Browse Heart Arrest studies →Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.
Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.
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Exclusion Criteria:
Participants receive real-time CPR performance feedback from a trained human CPR coach during an 18-minute simulated pediatric cardiac arrest. The CPR coach uses real-time compression rate, depth, and recoil data to provide goal-directed prompts based on Pediatric Advanced Life Support (PALS) targets, positive reinforcement for high-quality CPR, and guidance for compressor changes.
Participants use the AR-CPR system during an 18-minute simulated pediatric cardiac arrest. AR-CPR provides real-time visual feedback on chest compression rate, depth, and recoil through a head-mounted augmented reality display. The system displays numerical values and visual cues and provides goal-directed instructions when CPR performance falls outside established targets.
Device: AR-CPR
AR-CPR is a real-time augmented reality CPR feedback system designed to guide chest compression performance during pediatric cardiac arrest. The system uses a compression sensor containing an inertial measurement unit (IMU) and force-sensitive resistor (FSR) connected to a microcontroller. Sensor data are relayed to a Raspberry Pi 5 microcomputer running custom AR-CPR Coach software, which calculates chest compression rate, depth, and recoil. These metrics are transmitted wirelessly to a Vuzix M400 head-mounted display. The augmented reality interface provides numerical values and visual cues within the user's field of view. When performance is outside established targets, the system provides qualitative feedback and, for persistent deviations, escalates to explicit goal-directed instructions.
Percentage of Overall Excellent CPR
Percentage of chest compressions meeting the study-defined composite criterion for overall excellent CPR. This is a single composite outcome measure in which each chest compression is classified as meeting the outcome only when both compression rate and compression depth simultaneously meet American Heart Association Pediatric Advanced Life Support (AHA PALS) guideline targets. A compression must have both a rate of 100-120 compressions per minute and a depth of 5-6 cm to meet the composite outcome. If either the rate or depth is outside its target range, the compression does not meet the outcome. Rate and depth are therefore not evaluated as separate measurements for this primary outcome; they are simultaneous criteria used to determine whether each compression meets the single composite measure.
Time frame: Up to 18 minutes
Percentage of Compressions Meeting Guideline Rate Target
Percentage of chest compressions delivered at the AHA PALS guideline-recommended rate of 100-120 compressions per minute. Measured during the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Percentage of Compressions Meeting Guideline Rate Depth
Percentage of chest compressions delivered at the AHA PALS guideline-recommended depth of 5-6 cm. Measured during the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Percentage of Compressions With Adequate Recoil
Percentage of chest compressions meeting the study-defined criterion for adequate chest recoil. During the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Percentage of Perfect CPR
Percentage of chest compressions simultaneously meeting study criteria for compression rate, depth, and recoil. Measured during the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Mean Chest Compression Rate
Average chest compression rate, measured in compressions per minute, across the full simulated cardiac arrest event. Measured during the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Mean Chest Compression Depth
Average chest compression depth, measured in centimeters, across the full simulated cardiac arrest event. Measured during the 18-minute simulated pediatric cardiac arrest.
Time frame: Up to 18 minutes
Plan to share: No — Individual participant data will not be publicly shared because the study involves a relatively small, specialized population of healthcare providers recruited from a limited number of participating institutions, which may increase the risk of participant identification. Aggregate and de-identified study results will be reported in scientific publications and presentations.
Started Jun 2025 (actual). Primary completion is estimated for Mar 2028, 33 months after the start.
Of 204 non-industry interventional studies with no phase under Heart Arrest, half reached primary completion within 29 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 47. This study's planned 33 months is above that.
Counting every sponsor, half of 218 studies reached it within 28 months; a quarter within 10 and three quarters within 47.
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