Integrative Biomedical Research

Integrative Biomedical Research (Journal of Angiotherapy) | Online ISSN  3068-6326
685
Citations
1.4m
Views
736
Articles
Your new experience awaits. Try the new design now and help us make it even better
Switch to the new experience
Figures and Tables
REVIEWS   (Open Access)

Digital First Aid Interventions in Emergency Care: A Narrative Review of Artificial Intelligence, Augmented Reality, and Telemedicine for Bystander Support

Abdulrahman Faihan H. Alharthi 1, Tamadur Marzouq Alotaibi 1, Muqbil Abdullah Muqbil Alharbi 1, Mohammed Ayidh Onayzan Alrashid 1, Abdulrahman Assaf Darwish Alshammari 1, Saad Saeed N. Almazariqah 1, Abdullah Mathkar Nawar Alotaibi 1, Turky Faez Saeed Alqahtani 1, Sari Rashed Saleh Alharbi 1, Mohammed Zahim Humud Albeladi 2, Samer Mohammed Alfaifi 2, Faris Binyah K. Alyazidi 2

+ Author Affiliations

Journal of Angiotherapy 8 (8) 1-8 https://doi.org/10.25163/angiotherapy.8810741

Submitted: 09 June 2024 Revised: 16 August 2024  Published: 24 August 2024 


Abstract

The moments immediately following a medical emergency are, in many cases, decisive—yet they remain heavily dependent on bystander action, which is often uncertain, delayed, or incomplete. In recent years, the rapid expansion of digital technologies—including artificial intelligence (AI) chatbots, augmented reality (AR), and video-enabled telemedicine—has begun to reshape how real-time first aid guidance might be delivered. Still, despite this technological momentum, the actual clinical value of these tools is not entirely clear, and in some cases, perhaps less reliable than assumed. This narrative review synthesizes current evidence (2010–2024) on digital first aid interventions, with a focus on their effectiveness, usability, and clinical implications across emergency scenarios such as out-of-hospital cardiac arrest, stroke, trauma, and wound care. The findings suggest a somewhat uneven landscape. Video-assisted dispatch systems—particularly those enabling live interaction between bystanders and trained clinicians—consistently improve cardiopulmonary resuscitation (CPR) quality, influence emergency decision-making, and, in several studies, appear to be associated with improved survival outcomes. By contrast, commercial voice assistants demonstrate limited reliability, providing actionable CPR guidance in only a small proportion of cases and, at times, generating inconsistent or potentially misleading responses. Generative AI models offer a more adaptive and context-aware approach, yet their performance remains variable and, importantly, dependent on supervision and validation. Augmented reality applications, while promising in controlled or educational settings, still lack sufficient real-world evidence to support widespread deployment in emergency contexts. Across all technologies, issues of usability, cognitive load, trust calibration, and system integration emerge as persistent challenges. Taken together, the evidence suggests that digital first aid tools may indeed enhance bystander response—but only under specific conditions, particularly when integrated with professional oversight and structured protocols. Rather than replacing traditional emergency systems, these technologies seem better understood as extensions of them. Future progress will likely depend on rigorous validation, human-centered design, and careful alignment with clinical workflows to ensure both safety and effectiveness.

Keywords: First aid; artificial intelligence; augmented reality; telemedicine; bystander response, AI, CPR, emergency care

References


Alahi, M. E. E., Sukkuea, A., Tina, F. W., Nag, A., Kurdthongmee, W., Suwannarat, K., & Mukhopadhyay, S. C. (2023). Integration of IoT-enabled technologies and artificial intelligence (AI) for smart city scenario: recent advancements and future trends. Sensors, 23(11), 5206. https://doi.org/10.3390/s23115206

Aldridge, E. S., Perera, N., Ball, S., Finn, J., & Bray, J. (2022). A scoping review to determine the barriers and facilitators to initiation and performance of bystander cardiopulmonary resuscitation during emergency calls. Resuscitation plus, 11, 100290. https://doi.org/10.1016/j.resplu.2022.100290

Barsom, E. Z., Duijm, R. D., Dusseljee-Peute, L. W., Landman-van der Boom, E. B., van Lieshout, E. J., Jaspers, M. W., & Schijven, M. P. (2020). Cardiopulmonary resuscitation training for high school students using an immersive 360-degree virtual reality environment. British Journal of Educational Technology, 51(6), 2050-2062. https://doi.org/10.1111/bjet.13025

Bates, D. W., Levine, D., Syrowatka, A., Kuznetsova, M., Craig, K. J. T., Rui, A., ... & Rhee, K. (2021). The potential of artificial intelligence to improve patient safety: a scoping review. NPJ digital medicine, 4(1), 54. https://doi.org/10.1038/s41746-021-00423-6

Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., ... & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2019). Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation, 139(10), e56-e528. https://doi.org/10.1161/CIR.0000000000000659

Bushuven, S., Bentele, M., Bentele, S., Gerber, B., Bansbach, J., Ganter, J., ... & Ranisch, R. (2023). “ChatGPT, can you help me save my child’s life?”-Diagnostic Accuracy and Supportive Capabilities to lay rescuers by ChatGPT in prehospital Basic Life Support and Paediatric Advanced Life Support cases–an in-silico analysis. Journal of medical systems, 47(1), 123. https://doi.org/10.1007/s10916-023-02019-x

Clark, M., & Severn, M. (2023). Artificial intelligence in prehospital emergency health care. Canadian Journal of Health Technologies, 3(8).

Dabas, M., Schwartz, D., Beeckman, D., & Gefen, A. (2023). Application of artificial intelligence methodologies to chronic wound care and management: a scoping review. Advances in wound care, 12(4), 205-240. https://doi.org/10.1089/wound.2021.0144

Damaševicius, R., Bacanin, N., & Misra, S. (2023). From sensors to safety: Internet of Emergency Services (IoES) for emergency response and disaster management. Journal of sensor and actuator networks, 12(3), 41. https://doi.org/10.3390/jsan12030041

de Koning, E., van der Haas, Y., Saguna, S., Stoop, E., Bosch, J., Beeres, S., ... & Boogers, M. (2023). AI algorithm to predict acute coronary syndrome in prehospital cardiac care: retrospective cohort study. JMIR cardio, 7(1), e51375. https://doi.org/10.2196/51375

Gala, D., & Makaryus, A. N. (2023). The utility of language models in cardiology: a narrative review of the benefits and concerns of ChatGPT-4. International Journal of Environmental Research and Public Health, 20(15), 6438. https://doi.org/10.3390/ijerph20156438

Greenhalgh, T., Thorne, S., & Malterud, K. (2018). Time to challenge the spurious hierarchy of systematic over narrative reviews?. European journal of clinical investigation, 48(6), e12931. https://doi.org/10.1111/eci.12931

Haskins, B., Nehme, Z., Dicker, B., Wilson, M. H., Ray, M., Bernard, S., ... & Smith, K. (2021). A binational survey of smartphone activated volunteer responders for out-of-hospital cardiac arrest: Availability, interventions, and post-traumatic stress. Resuscitation, 169, 67-75. https://doi.org/10.1016/j.resuscitation.2021.10.030

Imran, M., Ofli, F., Caragea, D., & Torralba, A. (2020). Using AI and social media multimodal content for disaster response and management: Opportunities, challenges, and future directions. Information Processing & Management, 57(5), 102261. https://doi.org/10.1016/j.ipm.2020.102261

Juhrmann, M. L., Vandersman, P., Butow, P. N., & Clayton, J. M. (2022). Paramedics delivering palliative and end-of-life care in community-based settings: a systematic integrative review with thematic synthesis. Palliative medicine, 36(3), 405-421. https://doi.org/10.1177/02692163211059342

Kirubarajan, A., Young, D., Khan, S., Crasto, N., Sobel, M., & Sussman, D. (2022). Artificial intelligence and surgical education: a systematic scoping review of interventions. Journal of Surgical Education, 79(2), 500-515. https://doi.org/10.1016/j.jsurg.2021.09.012

Leigh, J. W., Gerber, B. S., Gans, C. P., Kansal, M. M., & Kitsiou, S. (2022). Smartphone ownership and interest in mobile health technologies for self-care among patients with chronic heart failure: cross-sectional survey study. JMIR cardio, 6(1), e31982. https://doi.org/10.2196/31982

Linderoth, G., Lippert, F., Østergaard, D., Ersbøll, A. K., Meyhoff, C. S., Folke, F., & Christensen, H. C. (2021). Live video from bystanders’ smartphones to medical dispatchers in real emergencies. BMC Emergency Medicine, 21(1), 101. https://doi.org/10.1186/s12873-021-00493-5

Lyngby, R. M., Clark, L., Kjoelbye, J. S., Oelrich, R. M., Silver, A., Christensen, H. C., ... & Folke, F. (2021). Higher resuscitation guideline adherence in paramedics with use of real-time ventilation feedback during simulated out-of-hospital cardiac arrest: A randomised controlled trial. Resuscitation plus, 5, 100082. https://doi.org/10.1016/j.resplu.2021.100082

Merchant, R. M., Abella, B. S., Abotsi, E. J., Smith, T. M., Long, J. A., Trudeau, M. E., ... & Asch, D. A. (2010). Cell phone cardiopulmonary resuscitation: audio instructions when needed by lay rescuers: a randomized, controlled trial. Annals of emergency medicine, 55(6), 538-543. https://doi.org/10.1016/j.annemergmed.2010.01.020

Morand, O., Larribau, R., Safin, S., Pages, R., Soichet, H., & Rizza, C. (2023). The integration of live video tools to help bystanders during an emergency call: protocol for a mixed methods simulation study. JMIR research protocols, 12(1), e40699. https://doi.org/10.2196/40699

Moumane, K., Idri, A., & Abran, A. (2016). Usability evaluation of mobile applications using ISO 9241 and ISO 25062 standards. SpringerPlus, 5(1), 548. https://doi.org/10.1186/s40064-016-2171-z

Munzer, B. W., Khan, M. M., Shipman, B., & Mahajan, P. (2019). Augmented reality in emergency medicine: a scoping review. Journal of medical Internet research, 21(4), e12368. https://doi.org/10.2196/12368

Murk, W., Goralnick, E., Brownstein, J. S., & Landman, A. B. (2023). An Opportunity to Standardize and Enhance Intelligent Virtual Assistant-Delivered Layperson Cardiopulmonary Resuscitation Instructions. medRxiv, 2023-03. https://doi.org/10.1101/2023.03.09.23287050

Nejati, H., Pomponiu, V., Do, T. T., Zhou, Y., Iravani, S., & Cheung, N. M. (2016). Smartphone and mobile image processing for assisted living: Health-monitoring apps powered by advanced mobile imaging algorithms. IEEE Signal Processing Magazine, 33(4), 30-48. https://doi.org/10.1109/MSP.2016.2549996

Pommerenke, C., Poloczek, S., Breuer, F., Wolff, J., & Dahmen, J. (2023). Automated and app-based activation of first responders for prehospital cardiac arrest: an analysis of 16.500 activations of the KATRETTER system in Berlin. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31(1), 105. https://doi.org/10.1186/s13049-023-01152-3

Ribino, P. (2023). The role of politeness in human–machine interactions: A systematic literature review and future perspectives. Artificial Intelligence Review, 56.https://doi.org/10.1007/s10462-023-10540-1

Sardar, P., Abbott, J. D., Kundu, A., Aronow, H. D., Granada, J. F., & Giri, J. (2019). Impact of artificial intelligence on interventional cardiology: from decision-making aid to advanced interventional procedure assistance. Cardiovascular interventions, 12(14), 1293-1303. https://doi.org/10.1016/j.jcin.2019.04.048

Scquizzato, T., Belloni, O., Semeraro, F., Greif, R., Metelmann, C., Landoni, G., & Zangrillo, A. (2022). Dispatching citizens as first responders to out-of-hospital cardiac arrests: a systematic review and meta-analysis. European Journal of Emergency Medicine, 29(3), 163-172. DOI: 10.1097/MEJ.0000000000000915

Shekhar, A., & Narula, J. (2022). Globally, GDP per capita correlates strongly with rates of bystander CPR. Annals of Global Health, 88(1), 36. https://doi.org/10.5334/aogh.3624

Smith, C. M. (2020). Improving public-access automated external defibrillator use in a volunteer first-responder system for out-of-hospital cardiac arrest (Doctoral dissertation, University of Warwick).

Smith, C. M., Wilson, M. H., Ghorbangholi, A., Hartley-Sharpe, C., Gwinnutt, C., Dicker, B., & Perkins, G. D. (2017). The use of trained volunteers in the response to out-of-hospital cardiac arrest–the GoodSAM experience. Resuscitation, 121, 123-126. https://doi.org/10.1016/j.resuscitation.2017.10.020

Strandqvist, E., Olheden, S., Bäckman, A., Jörnvall, H., & Bäckström, D. (2023). Physician-staffed prehospital units: a retrospective follow-up from an urban area in Scandinavia. International Journal of Emergency Medicine, 16(1), 43. https://doi.org/10.1186/s12245-023-00519-8

Todd, V., Dicker, B., Okyere, D., Smith, K., Smith, T., Howie, G., ... & Nehme, Z. (2023). A study protocol for a cluster-randomised controlled trial of smartphone-activated first responders with ultraportable defibrillators in out-of-hospital cardiac arrest: the first responder shock trial (FIRST). Resuscitation Plus, 16, 100466. https://doi.org/10.1016/j.resplu.2023.100466

Wüller, H., Behrens, J., Garthaus, M., Marquard, S., & Remmers, H. (2019). A scoping review of augmented reality in nursing. BMC nursing, 18(1), 19. https://doi.org/10.1186/s12912-019-0342-2

Yadav, K., Chamberlain, J. M., Lewis, V. R., Abts, N., Chawla, S., Hernandez, A., ... & Burd, R. S. (2015). Designing real-time decision support for trauma resuscitations. Academic Emergency Medicine, 22(9), 1076-1084. https://doi.org/10.1111/acem.12747

Yoon, M., Park, J. J., Hur, T., Hua, C. H., Hussain, M., Lee, S., & Choi, D. J. (2023). Application and potential of artificial intelligence in heart failure: past, present, and future. International journal of heart failure, 6(1), 11. https://doi.org/10.36628/ijhf.2023.0050

Zicari, R. V., Brusseau, J., Blomberg, S. N., Christensen, H. C., Coffee, M., Ganapini, M. B., ... & Kararigas, G. (2021). On assessing trustworthy AI in healthcare. Machine learning as a supportive tool to recognize cardiac arrest in emergency calls. Frontiers in Human Dynamics, 3, 673104. https://doi.org/10.3389/fhumd.2021.673104


Article metrics
View details
0
Downloads
0
Citations
92
Views

View Dimensions


View Plumx


View Altmetric



0
Save
0
Citation
92
View
0
Share