- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01872325
Improving Cardiac Arrest Diagnostic Accuracy of Emergency Medical Dispatchers
Improving the Cardiac Arrest Diagnostic Accuracy of 9-1-1 Emergency Medical Dispatchers
Study Overview
Detailed Description
Cardiac arrest is a leading cause of death in Canada; it is defined as the sudden cessation of cardiac mechanical activity. It is uniformly fatal if not treated within minutes. More than 85% of out-of-hospital cardiac arrest (OOHCA) occur in residential locations so public access to automatic external defibrillators, to restart the heart, are not helpful. The overall rate of survival for OOHCA rarely exceeds 8%.
Bystander cardiopulmonary resuscitation (CPR) is chest compression and ventilations provided by someone not on the emergency response team. A victim or cardiac arrest is almost 4 times more likely to survive when receiving bystander CPR. However, despite various attempts to improve bystander rates they have remained low, not exceeding 15% in Ontario. It has been shown that since the ambulance dispatch centres in Ontario implemented dispatch-assisted CPR instructions (given to callers while emergency vehicles were on the way), there was a significant increase in use.
Emergency medical dispatchers can identify about 70% of OOHCA cases over the phone. Agonal breathing (laboured breathing preceding death) may be misinterpreted as a sign of life, and is responsible for as much as 50% of missed diagnoses. There is no specific training on the significance of this sign, and minimal information about recognizing cardiac arrest. An educational intervention designed to better understand the significance of agonal breathing and to clarify the existing CPR instruction protocol will most likely increase the frequency of CPR instructions, bystander CPR rates, and potentially survival of victims of cardiac arrest.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Ontario
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Ottawa, Ontario, Canada, K1Y 4E9
- Ottawa Hospital Research Institute
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- presumed cardiac origin
- event occurs in the catchment area of Training or Control Site
- resuscitation is attempted by a bystander and/or the emergency responders
Exclusion Criteria:
- patients younger than 16 years old
- patients who are "obviously dead" as defined by the Ambulance Act of Ontario (decomposition, rigor mortis, decapitation, or other)
- trauma victims including hanging and burns
- cardiac arrest of non-cardiac origin including drug overdose, carbon monoxide poisoning, drowning, exsanguination, electrocution, asphyxia, hypoxia related to respiratory disease, cerebrovascular accident, and documented terminal illness
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Training site
All emergency medical dispatchers at a central ambulance communication centre in Ontario will participate in an educational program designed to improve cardiac arrest diagnostic accuracy.
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An education program will be developed using behaviour change techniques specifically mapped to address modifiable factors identified in a previous study.
These techniques will include: information about the significance of agonal breathing, modeling/demonstration of desired behavioural skills, rehearsal of desired skills, and monitoring/reinforcement and feedback.
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Control site
All emergency medical dispatchers at a central ambulance communications centre geographically remote from the Training Site and has a similar rate to the Training Site for cardiac arrests, bystander CPR rate, and survival
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Agonal Breathing
Time Frame: At the time of the cardiac arrest event
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By reviewing recordings of all cardiac arrest calls, including missed cases retrieved from a registry, document presence or absence of agonal breathing.
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At the time of the cardiac arrest event
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Cases Where Cardiac Arrest Was Recognized by the Ambulance Dispatcher
Time Frame: At the time of the cardiac arrest event
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By reviewing recordings of all cardiac arrest calls, collect information on dispatcher recognition of cardiac arrest to bystander implementation of chest compressions
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At the time of the cardiac arrest event
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants Who Received Bystander CPR
Time Frame: At the time of the cardiac arrest event
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The first member of the emergency response team to arrive at scene will document whether or not chest compressions have been initiated by someone prior to the arrival of emergency team
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At the time of the cardiac arrest event
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Number of Participants Surviving to Hospital Discharge
Time Frame: At the time of the cardiac arrest event to discharge alive from hospital (varies, depending on length of hospital stay)
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Accessing hospital medical records or coroner's reports, assess survival of cardiac arrest victim as being discharged alive from hospital
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At the time of the cardiac arrest event to discharge alive from hospital (varies, depending on length of hospital stay)
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Collaborators and Investigators
Investigators
- Principal Investigator: Christian Vaillancourt, MD,MSc,FRCPC, The Ottawa Hospital Research Institute and University of Ottawa
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2012-0379-01H
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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