Accurate and fast neonatal heart rate assessment with a smartphone-based application - a manikin study

Susanna Myrnerts Höök, Nicolas J Pejovic, Gaetano Marrone, Thorkild Tylleskär, Tobias Alfvén, Susanna Myrnerts Höök, Nicolas J Pejovic, Gaetano Marrone, Thorkild Tylleskär, Tobias Alfvén

Abstract

Aim: This study determined the accuracy and speed of the NeoTapLifeSupport (NeoTapLS), a free smartphone application that aims to assess a neonate's heart rate.

Methods: We asked 30 participants with a variety of backgrounds to test the NeoTapLS, which was developed by our own nonprofit organisation Tap4Life, to determine a randomly selected heart rate by auscultation or palpation. The study was carried out in 2014 at Sachs' Children and Youth Hospital, Sweden, using a Laerdal SimNewB manikin that simulates true values. The NeoTapLS calculates the heart rate based on the user's last three taps on the smartphone screen.

Results: A total of 1200 measurements were carried out. A high correlation was found between measured and true values by auscultation (correlation coefficient 0.993) as well as by palpation (correlation coefficient 0.986) with 93.5% of the auscultations and 86.3% of the palpations differing from the true value by five beats or fewer. The mean time to the first estimated heart rate was 14.9 seconds for auscultation and 16.3 seconds for palpation.

Conclusion: Heart rates could be accurately and rapidly assessed using the NeoTapLS on a manikin. A globally accessible mobile health system could offer a low-cost alternative to expensive medical equipment.

Keywords: Heart rate; Mobile health; Monitoring; Neonatal; Resuscitation.

©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Figures

Figure 1
Figure 1
(A, B, C) How the NeoTapLS is displayed on the smartphone screen. Tap to register the infant's heart rate. (A) Heart rate at 32 seconds <100, prepare for ventilation. (B) Heart rate at one minute <100, ventilate now! (C) Heart rate at one minute 45 seconds >100, newborn resuscitation is going well.
Figure 2
Figure 2
A simulation in which a participant, who agreed to be photographed, auscultated the precordium of the manikin and at the same time tapped the screen of the smartphone with the NeoTapLS application.
Figure 3
Figure 3
Deviation from simulated heart rate by auscultation and palpation.
Figure 4
Figure 4
(A, B) Boxplot and whiskers showing all estimated heart rate assessments with NeoTapLS versus simulated heart rate of the manikin (A) by auscultation and (B) by palpation.

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