|Poonpong Boonbrahm||School of Informatics, Walailak University, Nakorn si Thammarat 80160, Thailand|
|Charlee Kaewrat||School of Informatics, Walailak University, Nakorn si Thammarat 80160, Thailand|
|Salin Boonbrahm||School of Informatics, Walailak University, Nakorn si Thammarat 80160, Thailand|
CPR, or Cardiopulmonary Resuscitation, is a lifesaving technique useful for the case in which someone’s heartbeat or breathing has stopped due to heart attack. Without proper CPR, nine out of ten patients die. The American Heart Association recommends CPR with chest compressions in the event of witnessing such an incident. For proper CPR training, taking a class with a CPR instructor is usually the best choice, but it is not practical and costly for mass training, especially in schools and universities. There are many new techniques available that can replace traditional CPR training and Augmented Reality (AR) is one of them. AR is the technology that integrates virtual objects or environments, created by digital technology, with the real world. Augmented Reality using marker-based technique is a good option, since a trainee can have a realistic look at the patient, know the position of the hand on the chest, identify the number of chest compressions per minute, and also know the pressure that he or she puts on the chest. Besides that, the status of the operation can be displayed along with a recording system for analysis. In this research, we chose marker-based AR due to its precision in distance measurement. For measuring the pressure on the chest, we use a marker-marker interaction technique. Unity 3D cross-platform game engine and Qualcomm's Vuforia—an augmented reality software development kit (SDK) for mobile devices that enables the creation of augmented reality applications—are required. The results from our experiment with a group of people with non-CPR training confirm that the configuration increases the speed and accuracy of CPR training.
Augmented reality; CPR Training; Marker-based AR; Marker-Marker Interaction
In the past few years, there have been some significant changes in the field of healthcare thanks to advanced information technology, both in terms of quality and variety of services. One of the techniques that can be applied to healthcare services, and that seems to be the most promising, is Augmented Reality (AR). AR is the technology that integrates virtual objects or environments, created by digital technology, with the real world. With AR technology, digital objects, such as 3D models, text, video, and sound generated by a digital computer can overlay on top of the real world at the exact point where it is designated. The potential for applying AR to the health care system is enormous, ranging from practice to training. In medical practice, a real-time image of the patient from a scanning system such as MRI or CT scan can be overlaid on the patient’s body, making diagnosis more accurate. In the operation room, vital images and information to support the surgeons are available in front or on top of the patient, allowing the surgeon to access that information without having to look away from the patient. For training, there are many areas in healthcare to which AR can be applied for better performance. Examples of AR in medical training range from teaching medical or healthcare students to learn human anatomy using 3D visualization, to helping train healthcare students to master the techniques for checking vital signs. The advantage of using AR in training is that it can be more systematic and specific. Besides that, since marker-based AR can be programmed so that each marker can interact with others, giving the results in terms of data such as distance and time, a trainee can see all the details of the instruction, including their performance, in real time, enabling them to adjust their pace for better performance.
As mentioned, the potential uses of AR for training are numerous and largely untapped; one of them is CPR training. CPR, or Cardiopulmonary Resuscitation, is a lifesaving technique useful for the case in which someone’s heartbeat or breathing has stopped due to heart attack. In the United States, more than 350,000 people experience heart attacks each year, and without proper CPR, nine out of ten die. The American Heart Association recommends CPR with chest compressions in the event of witnessing such an incident. For the untrained person, hands-only CPR is enough, entailing 100 to 120 uninterrupted chest compressions a minute. The CPR process keeps oxygenated blood flowing to the brain and other vital organs until more medical treatment can restore normal heart rhythm. There are many ways of receiving training in CPR besides taking a class with a CPR instructor, though it is the best option if time permits. In the case where many people are taking the course or would like to self-train, a CPR training manikin is the best option. The drawback for this option is the cost of the manikin and the restrictions on locations for training. As the number of heart attack victims is very high and the chance of survival is low without proper CPR treatment, we need new and engaging learning methods for CPR education, especially in schools or universities, to increase the number of people who know how to perform proper CPR. Now, there is another option, i.e., using application software, such as popular AR technology. Since there is still some limitation on using the software, which requires some extra equipment such as Microsoft’s Hololens or Google glasses, and also due to the reality of the CPR process and environment, in this research we focus on developing an AR system that represents the realistic CPR training environment using the nearly ubiquitous technology of a smartphone. Since CPR is known to be both hard to teach and, once learned, hard to retain, using a smartphone with AR applications makes it possible for people to train any time they want and as many times as they need.
In this paper, we presented an interactive marker-based AR system for CPR training, which is a low-cost and high-efficiency system for group training. Even though our system used eye goggles connected to iOS or Android mobile phones, which are cumbersome, it is practical enough for users since many people are already using them for playing VR and AR games. Soon, low-cost, lightweight AR glasses with good viewing experience will be available, so CPR training using AR techniques will be among the top choices for users.
Comparing this CPR training using AR technology with other methods (either using CPR training manikins or taking a class with a CPR instructor), it was evident that our approach has some advantages. One example is the accuracy of training in which trainees get all the information about their practice in real time, so they can adjust their performance to meet the goal quickly. Another advantage is cost saving, because the system needs only a mobile phone that almost everybody has, so no need for expensive equipment. In summary, training many people to perform CPR correctly is possible with AR technology, so in the future, with this kind of CPR training application, many lives can be saved.
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