The efficacy of a smartwatch-based haptic metronome in standardising chest compression rate: a crossover simulation study.
Resuscitation plus · 2026-06-22 · Quasi-experimental
Abstract
BACKGROUND: High-quality chest compressions are crucial for effective resuscitation, yet maintaining the guideline-recommended rate of 100-120 compressions per minute is challenging, particularly in stressful and noisy prehospital environments. Haptic feedback delivered through wearable technology may offer a reliable alternative to auditory cues by providing tactile rhythm guidance. OBJECTIVE: To evaluate the efficacy of a smartwatch-based haptic feedback system delivering 110 vibrations per minute in improving adherence to the target chest compression rate during simulated adult cardiac arrest, compared with unassisted cardiopulmonary resuscitation (CPR). METHODS: In this prospective, experimental, simulation-based crossover study, 80 volunteers (paramedic students, intern physicians, emergency medicine residents, and laypersons; n = 20 each) performed one minute of self-paced chest compressions on a Laerdal Little Anne QCPR manikin and, after a five-minute rest, repeated the task with a Samsung Galaxy Watch 5 delivering haptic impulses at 110 bpm. The primary endpoint was the percentage of compressions performed within the 100-120 bpm target range; secondary endpoints were the proportion of participants achieving the target rate and self-reported user experience. The study was designed and is reported in accordance with the Reporting Guidelines for Health Care Simulation Research. RESULTS: Haptic guidance substantially improved the percentage of compressions within the guideline-recommended 100-120 bpm range. The proportion of participants achieving the target compression rate increased from 45.0% at baseline to 93.75% with smartwatch-assisted feedback (McNemar test, p < 0.001). The mean percentage of compressions delivered within the target range rose from 43.55% during unassisted CPR to 90.71% with haptic guidance, and significant within-group improvements were observed across all four professional cohorts. Participant experience was highly positive: 93.75% endorsed the device for real-world clinical use, 95.00% found it useful for CPR training, and 95.00% expressed willingness to use it again. CONCLUSION: A smartwatch-based haptic metronome significantly improved adherence to the guideline-recommended chest compression rate across all experience levels. Given its high user acceptability and resilience to environmental noise, this wearable technology may provide a practical, low-cost adjunct to improve CPR quality in both training and prehospital settings.