Christopher M. Horvat, MD, MHA, MSIT
Safar Center Associate Director, Informatics
Safar Center investigators led and contributed to a novel JAMA Internal Medicine study evaluating whether artificial intelligence can guide bystanders through cardiopulmonary resuscitation during out-of-hospital cardiac arrest. The Safar-affiliated investigators on the study were Christopher M. Horvat, MD, MHA, MSIT, Clifton Callaway, MD, PhD; and Patrick M. Kochanek, MD, MCCM.
The team first benchmarked several popular AI models against guideline-based CPR instruction checklists. While general-purpose models performed well on basic CPR steps, they missed important elements needed for high-quality resuscitation. These gaps informed the development of ChatCPR, an open-source AI-powered CPR coaching agent grounded in dispatcher training materials and resuscitation best practices.
In simulated emergency scenarios, ChatCPR achieved 100% adherence to both basic and advanced CPR instruction criteria. When tested against de-identified real 911 cardiac arrest calls, ChatCPR outperformed human dispatchers in every head-to-head comparison, particularly for patient assessment, compression depth and rate, and chest recoil guidance.
The findings point toward a future in which carefully tested AI tools support, rather than replace, bystanders, dispatchers, and first responders during time-critical emergencies.
“This major advancement in resuscitation science deserves placement on the timeline of CPR breakthroughs and the investigators are to be commended,” says Dr. Robert Clark, Interim Director of the Safar Center for Resuscitation Research.
Breakthroughs in CPR
1903: Dr. George Crile, Cleveland, Ohio reports successful closed chest compressions in a human.
1956: Drs. James Elam and Peter Safar at Baltimore City Hospital prove that mouth-to-mouth resuscitation is an effective lifesaving method.
1956: Dr. Paul Zoll uses an external defibrillator successfully on a human heart.
1960: Dr. William Kouwenhoven, James Jude, and Safar combine mouth-to-mouth breathing with chest compressions to create modern-day CPR.
1960: The Resusci-Anne mannequin, pioneered by Asmund Laerdal and Bjorn Lind, presented at the First International Symposium on Resuscitation.
1981: Dispatcher-assisted CPR is established using 911.
1985: The first AED designed for public use is introduced.
2026: ChatCPR, a readily deployable AI-enabled CPR instructor is introduced.