Dispatcher-Assisted Resuscitation Trial (DART)

October 28, 2014 updated by: Susan Damon, Public Health - Seattle and King County

Randomized Trial of Dispatcher-Assisted CPR:Chest Compression Alone Versus Chest Compression Plus Ventilation

The purpose of this study is to determine whether dispatcher-assisted CPR instructions with compressions and ventilations versus dispatcher-assisted CPR instructions with compressions only improves survival from out-of-hospital cardiac arrests.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Out-of-hospital cardiac arrest, a condition characterized by a person suddenly collapsing due to heart stoppage, is a leading cause of death in the United States. In out-of-hospital cardiac arrest, survival is dependent upon what the American Heart Association has termed the chain of survival which includes quick activation of the 9-1-1 system, prompt cardiopulmonary resuscitation (CPR), early defibrillation, and qualified advanced life support care (paramedic care). CPR allows for some circulation and delivery of oxygen to vital organs when the heart is no longer beating on its own. However, in some instances, the citizen bystander has not been trained in CPR, presenting a circumstance where the cardiac arrest victim may not receive CPR until the arrival of emergency medical services (EMS) personnel (i.e., paramedics). The delay in CPR adversely affects outcome and dcreases the chance of survival. In response to this need, the EMS Division of Public Health - Seattle and King County developed and instituted telephone CPR instructions that could be provided "on-the-spot" during a cardiac arrest by the emergency medical (9-1-1) dispatcher. The instructions are designed to be given over the phone to persons who have not had previous CPR training so that they can initiate CPR prior to the arrival of EMS personnel and have been termed "dispatcher-assisted" CPR. The dispatcher instructions provided by the dispatch agencies of King County include the standard "full" CPR protocol of ventilations (breathing into the victim's mouth to inflate the lungs) and chest compressions(pumping on the patients chest to help circulate the blood). The ventilations oxygenate the blood while the chest compressions pump the oxygenated blood forward. This EMS program has led to a considerable increase in the proportion of cardiac arrest victims in King County that receive citizen bystander CPR prior to EMS arrival and has been associated with improved survival (appendix 1).

Comparison: Dispatcher-assisted CPR instructions with compressions and ventillations compared to dispatcher-assisted CPR instructions with compressions only.

Study Type

Interventional

Enrollment (Actual)

5494

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United Kingdom
    • England
      • London, England, United Kingdom
        • London Ambulance Service
  • United States
    • Washington
      • Olympia, Washington, United States
        • Thurston County Dispatch
      • Seattle, Washington, United States, 98104
        • Division of Emergency Medical Services, Public Health - Seattle and King County

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

9 years and older (ADULT, OLDER_ADULT, CHILD)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Cardiac arrest events where CPR is not ongoing but a bystander is willing to attempt with assistance

Exclusion Criteria:

  • Pregnancy
  • Prisoners
  • Cardiac arrest due to asphyxia, drowning, hanging, or electrocution

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
ACTIVE_COMPARATOR: 1
When a 911 call is determined to be a cardiac arrest, the caller reporting the event who needs or desires instructions to perform CPR while waiting for EMS to arrive will receive dispatcher-assisted CPR instructions with chest compressions only
Other: dispatcher-assisted CPR instructions with compressions only
Delivery of telephone CPR instructions to lay callers with hands-only chest compressions when the patient is identified to be in cardiac arrest
ACTIVE_COMPARATOR: 2
When a 911 call is determined to be a cardiac arrest, the caller reporting the event who needs or desires instructions to perform CPR while waiting for EMS to arrive will receive dispatcher-assisted CPR instructions with chest compressions and breaths
Other: dispatcher-assisted CPR with compressions & ventilations
Delivery of telephone CPR instructions to lay callers with chest compressions and ventilations when the patient is identified to be in cardiac arrest

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Survival to hospital discharge
Time Frame: varied
assessed at hospital discharge
varied

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Neurological status at hospital discharge
Time Frame: varied
assessed at hospital discharge
varied

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Public Health - Seattle and King County

Investigators

  • Principal Investigator: Mickey S Eisenberg, MD, PhD, Division of Emergency Medical Services, Public Health - Seattle and King County

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2004

Primary Completion (ACTUAL)

August 1, 2012

Study Completion (ACTUAL)

August 1, 2012

Study Registration Dates

First Submitted

September 13, 2005

First Submitted That Met QC Criteria

September 13, 2005

First Posted (ESTIMATE)

September 22, 2005

Study Record Updates

Last Update Posted (ESTIMATE)

October 29, 2014

Last Update Submitted That Met QC Criteria

October 28, 2014

Last Verified

October 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • RARC-0001-01

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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